There's a Good Chance Your Antibiotic Prescription Is Unnecessary

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Nearly one in three antibiotic prescriptions is totally unnecessary, finds the first major study to measure the overuse of these drugs. Of the 47 million excess prescriptions per year, most are doled out for viral infections, which don’t respond to antibiotics in the first place. Meanwhile, antibiotics are fueling the spread of life-threatening antibiotic-resistant bacteria.

These alarming findings come from data pulled from doctors’ offices and emergency rooms across the U.S. in 2010 and 2011. Led by the Centers for Disease Control and Prevention, a team of researchers determined that 13 percent of all doctors’ interactions resulted in an antibiotic script. Forty-four percent of those were for respiratory conditions such as bronchitis, allergies, sinus infections, pneumonia, and even the common cold. In only half of those cases were antibiotics medically necessary.

Doctors and disease experts have been warning about the widespread misuse of these drugs for years. Their prevalence encourages bacteria to mutate and become resistant, rendering antibiotics ineffective when they’re truly needed to save lives. On top of that, since antibiotics wipe out so much bacteria in your system, they allow resistant species to flourish, some of which are deadly. The most notorious, Clostridium difficile, was obscure 20 years ago, but infected almost half a million Americans in 2011, killing 29,000.

In the scope of total antibiotic use, life-threatening infections like C. difficile are still fairly rare. However, less-severe diarrhea, as well as allergic reactions, are very common. If you’re already sick with some sort of respiratory infection, these harsh side effects can take a huge toll on your body. “Basically, you’re taking a medicine with plenty of potential to harm you and zero potential to help,” says Dr. Jeffrey Linder, study co-author and an internist and primary-care clinician-investigator at Brigham and Women’s Hospital in Boston. He says the only respiratory issues antibiotics should be given for are pneumonia, strep throat, the roughly 10 percent of sinus infections that are bacterial, and ear infections, which are extremely rare in adults.

Given all the nasty downsides of antibiotics, why are doctors still penning scripts so liberally? “I think most know they shouldn’t be prescribing antibiotics for the common cold and other viral infections,” Linder says. “It’s more that they think patients expect to be prescribed antibiotics. We’ve trained patients to expect them.”

But Linder believes far fewer patients explicitly seek out antibiotics than physicians think. “In reality, the overwhelming majority just want a diagnosis,” he says. “They are perfectly happy not getting antibiotics, so long as they feel the doctor has taken the time to listen to their concerns.” Even so, many physicians are too scared to advise against antibiotics, in part because they’re being rated on patient-satisfaction surveys. “I hear doctors give this reasoning all the time,” Linder says. “But there is no established link between antibiotic prescribing and patient satisfaction. Satisfaction comes from the doctor explaining their health issue.”

Since your doctor might just assume you’ll want antibiotics if you come in hacking, sneezing, or wheezing, the onus is on you to initiate the discussion. “Say right away that you only want an antibiotic if absolutely necessary,” Linder says. “This will totally change a physician’s attitude toward a patient.” Your doctor will be more likely to level with you about your health, he says, and whether or not you really need these drugs. And if you are offered antibiotics, make sure the proper tests have been done to warrant a prescription, such as a strep test or a chest X-ray to detect pneumonia. Never take antibiotics “just in case.”