Antibiotic Use Varies by Region, Doctor
Feb. 11, 2003 — The chances of walking out of your doctor’s office with a prescription for a powerful antibiotic to treat a cold, cough, or sore throat may depend on where you live and what type of doctor you see.
A new study shows internists are nearly two and half times more likely than family or general physicians to prescribe broad-spectrum antibiotics in treating acute respiratory tract infections, such as the common cold, sore throats, sinus infections, and sinusitis. In addition, doctors in the Northeast and South are also more than twice as likely to choose an antibiotic in treating these conditions.
In most cases, researchers say the use of such powerful antibiotics is usually not necessary to treat these types of infections unless there are other complications. But even in cases where use of an antibiotic may be justified, many experts have expressed concern over the current overuse of the newer antibiotics, including Cipro, Augmentin, and Biaxin, which are effective against broad ranges of bacteria.
According to researchers, use of these antibiotics as a first-line of treatment against these relatively mild types of infections could promote the growth of bacteria that is resistant to treatment, as well as increase healthcare costs. Despite these risks, statistics show that the antibiotics are commonly used, but little is known about the doctors who prescribe them or the people who take them.
In the study, published in the Feb. 17 issue of The Journal of the American Medical Association, researchers used data from the National Ambulatory Medical Care Survey of 1,981 adults who were seen by doctors between 1997 and 1999 for the common cold or other nonspecific upper respiratory tract infections.
Researcher Michael A. Steiman, MD, of the VA Medical Center in San Francisco, Calif., and colleagues found that antibiotics were prescribed to 63% of patients with these conditions, ranging from 46% of patients with a common cold to 69% of those with sinusitis.
More powerful, broad-spectrum antibiotics were selected for 54% of patients who were prescribed an antibiotic, including more than half of those with a common cold.
Most colds are caused by viruses, which do not respond to antibiotics. Antibiotics only fight bacterial infections.
Researchers found the most powerful predictors of prescribing a broad-spectrum antibiotic were the physician’s specialty and geographic locations. Internists were 2.4 times more likely to prescribe these drugs than general and family practitioners, and doctors in the Northeast and South were both about two and a half times more likely to do the same.
Factors that made an antibiotic prescription less likely to happen in these cases were black race, lack of health insurance, and membership in a health maintenance organization.
Researchers say this wide variety in antibiotic use suggests that there’s a lot of room for improvement in doctor prescribing patterns.
SOURCE: The Journal of the American Medical Association, Feb. 17, 2003.
