August 19, 2009

Antibiotic Prescriptions On The Decline

According to a new report, fewer U.S. patients are receiving inappropriate antibiotics for coughs, colds, and ear infections.

The trend may be due to new respiratory vaccines such as Wyeth's Prevnar, or new doctor guidelines says Dr. Carlos Grijalva of Vanderbilt University who led the team of researchers.

The team found that prescriptions for acute respiratory infections such as colds, flu, and ear infections fell by one-third between 1995 and 2006.

Doctor visits for the infections also fell.

"The decreases observed in antibiotic prescriptions in children younger than 5 years were largely related to decreases in otitis media (ear infection) visit rates," the team wrote in the Journal of the American Medical Association.

Prescription rates for broad spectrum antibiotics also rose during the time.  Researchers are suggesting doctors do more to limit the use of unneeded antibiotics, in response to the data.

Experts have warned that the overuse of antibiotics can breed drug-resistant bacteria.

If bacteria is not killed by an antibiotic, it can flourish when the patient stops using the antibiotics.

These drug-resistant genes are then passed on to other bacteria in a quick evolutionary change.

Currently, penicillin is useless against half of the known U.S. Staphylococcus aureus infections due to the evolutionary nature of the bacteria.

In this report, Grijalva and his team studied 12 years of U.S. data on 6.2 billion doctor visits.

Visits for acute respiratory infections fell by 17 percent over the period for children under 5, while prescriptions for antibiotics for the infections dropped 36 percent with the same age group.

The use of antibiotics for ear infections fell 36 percent, while doctor visits for ear infections dropped 33 percent.

The numbers are due to influenza vaccines and to Prevnar, which has annual sales of over $3 billion, the researchers said.

The rate of prescribing antibiotics for children over 5 and adults also went down by 18 percent.

"Our results indicate that overall antibiotic prescription rates have decreased significantly. These changes coincided with efforts to reduce inappropriate antibiotic prescribing and the initiation of routine infant immunization with pneumococcal conjugate vaccine," the researchers wrote.

According to Grijalva, more work is still needed to further decrease the rate at which doctors prescribe antibiotics.


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