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