Docs Giving Wrong Rx To Kids With Sore Throats?

Copyright 2005 Daily News Central
For years, there has been concern that antibiotics are
overprescribed, and with good cause Despite clear guidelines
calling for prior testing, physicians prescribed antibiotics in
53 percent of sore throat cases in children, researchers from
Brigham and Women’s Hospital (BWH) and Children’s Hospital
Boston found in a recent study
This represents significantly more prescriptions than warranted
for actual rates — 15-36 percent — of strep throat among kids
with sore throat Furthermore, almost half of those
prescriptions were given in the absence of a test Details of
this research appear in the November 9, 2005, issue of the
Journal of the American Medical Association
Group A streptococcal pharyngitis, or strep throat, is the most
common cause of sore throat for which antibiotics are indicated
However, many leading health organizations, including the
Centers for Disease Control and Prevention and the American
Academy of Pediatrics say that a common “strep” test should be
performed prior to prescribing recommended antibiotics
Antibiotic-Resistant Bacteria
“This study demonstrates that children with sore throat are
frequently given unnecessary antibiotics,” says lead author
Jeffrey A Linder, MD, MPH, a BWH internist
“This overprescribing of antibiotics could be easily remedied by
following known guidelines, which include doing a simple,
inexpensive strep test,” he adds
“This is critical for not just children but all patients,” Dr
Linder notes, “as unnecessary prescription of antibiotics can
lead to a variety of issues, including increased costs, the
potential development of antibiotic-resistant bacteria, and
adverse drug effects”
Researchers analyzed data from children aged 3 to 17 years from
1995 to 2003 with sore throat who visited office-based
physicians, hospital outpatient departments and emergency
departments
Among an estimated 73 million visits for sore throat over this
time period, physicians prescribed antibiotics in 53 percent of
the cases, the researchers found
Just 15 to 36 percent of children with sore throat actually have
the strep throat bacterium, according to estimates But only 53
percent of those who were given the antibiotics had been tested
first
Testing Is Underused
Over the eight-year time period of the study, physicians
prescribed antibiotics less frequently, the researchers found,
which suggests an encouraging trend In 1995, 66 percent of
cases were given antibiotics, decreasing to 54 percent of cases
in 2003
Still, there was no decrease in the prescribing of
non-recommended antibiotics, which made up 27 percent of
antibiotic prescriptions, Dr Linder points out Recommended
antibiotics for the treatment of strep throat are penicillin,
amoxicillin, erythromycin and first-generation cephalosporins
“Strep testing is underused, and physicians should be ordering
this important diagnostic test before prescribing antibiotics to
kids with sore throat,” emphasizes Dr Linder
“Instead of writing a prescription, physicians should order a
test and make sure they are treating kids’ symptoms by offering
a pain medication like acetaminophen or ibuprofen,” he advises

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