BOSTON, MASSACHUSETTS. The only common bacterial cause of sore throats requiring
antibiotics is Group A Streptococcus, and the prevalence of this particular
throat infection is about 10%. This infection is universally susceptible
to penicillin. Around 1993 the prescribing rate for adults seeking medical
help for a sore throat dropped from 80% to 70%. But even at 70%, antibiotic
prescribing is inappropriate in this setting. With the growing importance
of resistance to antibiotics, an interesting question concerns the
prescribing patterns over the subsequent years. A recent study has
examined this issue. The investigators determined the percentage of
sore throat visits resulting in an antibiotic prescription and further
stratified by emergency department visits or primary care. For all visits
and primary care, the percentage has varied between 53% and 65% between
2000 and 2010. For ED visits, the percentage was on average about 54%.
Inappropriate treatment continues unabated. The authors point out that
the practice of prescribing antibiotics to those unlikely to benefit is
not benign. In addition to the issue of drug resistance, antibiotics
can cause diarrhea and in rare case a serious adverse drug reaction. In
addition, they estimate that between 1997 and 2010 inappropriate antibiotic
prescriptions cost about a half a billion dollars. What they fail to
mention is the adverse effect on beneficial gut bacteria.
Barnett ML, Linder JA. Antibiotic Prescribing to Adults With Sore
Throat in the United States, 1997-2010.
JAMA Intern Med 2013 October 3
Barnett ML, Linder JA. Antibiotic Prescribing to Adults With Sore Throat in the United States, 1997-2010. JAMA Intern Med 2013 October 3