October 3rd, 2013
12:00 PM ET

Doctors still overprescribing antibiotics

With all the talk of "superbugs" and antibiotic-resistant bacteria, you might think prescriptions for unnecessary antibiotics is relatively infrequent, especially for conditions where these drugs rarely work.

New research from Brigham and Women's Hospital in Boston suggests the opposite. Dr. Michael L. Barnett, lead author, and Dr. Jeffrey A. Linder, senior author, found that prescriptions of antibiotics for sore throat and acute bronchitis are far more common than they should be.

"You have a viral infection for which the antibiotics are not going to help, and you’re putting a chemical in your body that has a very real chance of hurting you," Linder said. Side effects of antibiotics include diarrhea, vaginitis in women, interactions with other medications and more serious reactions in a small number of people.

Also concerning: When you take antibiotics, there's a chance the disease you're fighting - or other bacteria in your body - will mutate, making it more resistant to antibiotics in the future.

"People may have infections that are harder to treat down the line because we're overusing antibiotics today," Linder said.

Disturbingly, says Linder, if you have taken an antibiotic recently there is a measurable amount of antibiotic-resistant bacteria on and inside you. It's not possible to say any particular person is going to end up with an infection that's resistant to antibiotics because of taking these drugs. But science has shown that community levels of antibiotic use are related to rates of antibiotic-resistant bacteria, Linder said.

Results from two studies by Linder and Barnett were presented at IDWeek 2013, a meeting of health professionals, this week.

Sore throat

In a research letter published in the journal JAMA Internal Medicine, the researchers showed that while only 10% of adults with sore throat have strep, the specific condition requiring antibiotics, doctors prescribe antibiotics in 60% of sore throat cases.

The study authors used data from large nationally representative surveys of ambulatory care in the United States: The National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. The surveys are sources of information on physicians and their practices.

Linder and Barnett analyzed data from 1997 to 2010 for more than 8,000 sore throat visits, from patients who did not have injuries, immunosuppression or other infectious diagnoses at the same time. Based on this information, they determined that physicians have been prescribing antibiotics in about 60% of sore throat visits since around 2000.

They also found that prescriptions for penicillin, the choice antibiotic for strep throat treatment, held steady at 9%, while the more expensive alternative azithromycin has been prescribed more and more. In 1997 to 1998, prescriptions for azithromycin for sore throat were too uncommon to reliably measure; in 2009 to 2010 it was prescribed in 15% of visits.

There are limitations to this study, however; the researchers have no way of knowing whether individual prescriptions for antibiotics are appropriate, and the surveys only include patients seen in clinic or emergency department settings.

"The financial cost of unnecessary antibiotic prescribing to adults with sore throat in the United States from 1997-2010 was conservatively $500 million," the study noted. The cost could have actually been 40 times more expensive because of diarrhea and other side effects from antibiotics.

Acute bronchitis 

Researchers also found alarming trends regarding antibiotic overprescribing for acute bronchitis using nationally representative surveys. This study, unlike the research letter, has not been published in a peer-reviewed journal but was presented at IDWeek 2013.

Ideally, says Linder, antibiotics would almost never be prescribed for acute bronchitis because of the abundance of evidence that they do not actually help this condition.

Yet the prescribing rate of antibiotics for acute bronchitis nationally has remained steady over the past 30 years around 73%, he said.

Researchers excluded anyone who had a chronic lung disease such as asthma and emphysema from this study.

Why so many antibiotics? 

Part of the problem of overprescribing is patient demand - people ask for antibiotics because they think these drugs will make them feel better. The other side of the coin is that many doctors have been prescribing antibiotics in abundance for years and are following old habits.

"I think there’s a discussion that should be happening between patient and doctor that doesn’t happen, that automatically leads to an antibiotic prescription," Linder said.

If you have a sore throat, for instance, you can tell your doctor that you want to know if you have strep - and that if you don't have it, you don't need an antibiotic.

soundoff (732 Responses)
  1. rgreeniwa

    By far the worst offender of antibiotic overuse is in the meat and poultry industries. The daily doses of antibiotics to chickens, cattle, pigs, etc. far, far outnumber those given to humans. And then, antibiotic-laced meat is eaten by humans, further increasing the likelihood of resistance forming.

    Therefore the prime area to be concerned about is in the food industry, not so much the medical industry. Unfortunately, this fact seems to be overlooked every time an article like this runs.

    October 3, 2013 at 13:16 | Report abuse | Reply
    • gager

      It is not over use of a anti bacterial. Eventually all bacteria will mutate to resist all medicine that is now available. It is and will always be a war of us against them(bacteria). Without the animal protection, animals would have major die offs.

      October 3, 2013 at 17:26 | Report abuse |
    • .

      Gager, farm animals receive antibiotics because they now live in factory farms where conditios are so apalling, they would be very unhealthy without antibiotics. The answer is to get rid of current factory farming practices and keep animals in conditions where they can remain healthy all by themselves. Having them live in conditions where they aren't constantly up to their hocks in feces and urine and breathing in ammonia would be a great start. Keep the antibiotics for when they are really needed, which is for treatment, not prophylaxis.

      October 3, 2013 at 18:23 | Report abuse |
    • Mr.KnowItAll

      Hundreds of billions of dollars have been spent to promote the use of antibiotics, hormones, and growth promoters, for livestock. The Livestock Production Industry does NOT know how to raise livestock any other way, and still meet the demand. Thirty years of research funded by the Pharmaceutical Industry, is where we are today! The consumer demands cheap prices and this is what has been delivered. You get what you pay for!

      October 3, 2013 at 19:17 | Report abuse |
    • grist

      The reason we have factory farms is because that is the only way to produce enough meat to satisfy the current demand. The solution is to eat less meat. There are good sources of protein which are more healthy than meat. Try some quinoa!

      October 4, 2013 at 09:02 | Report abuse |
    • jamiehardinphotography

      They don't use antibiotics for poultry that you eat. The animals only live 6-8 weeks and it would be a waste of money. Same with growth hormones. Contrary to popular misconceptions, poultry grow so large because of selected genetics that have been bred into the animals since the 1950's. Do some research before making such comments.

      October 4, 2013 at 11:42 | Report abuse |
    • Jenni Simonis

      Don't use antibiotics in the poultry we eat? Guess maybe someone should tell the poultry companies, National Chicken Council, etc. that. They even have a special label "Raised without Antibiotics" for chicken that was raised without antibiotics. You won't find that label on much poultry because most are indeed given various antibiotics.

      October 4, 2013 at 18:41 | Report abuse |
  2. Valentijn

    So can someone explain to me why I can't get antibiotics for a sinus infection I've now had for 5 MONTHS? Is massive amounts of thick dark yellow mucous oozing out of my nose and/or chocking me supposed to be the new "normal"?

    October 3, 2013 at 13:58 | Report abuse | Reply
    • gager

      It is a virus...not a bacteria.

      October 3, 2013 at 17:37 | Report abuse |
    • Sandy

      I feel your pain. I had a primary care physician who didn't believe in prescribing antibiotics for bronchitis. It once took me over two months to kick a bad attack, which unfortunately overlapped Christmas and kept me from Christmas carols, etc.. That I had a bad attack shouldn't have surprised him, as I have asthma. Once I started seeing an allergist, I started getting antibiotics as soon as evidence of infection surfaced, and I felt better within a week ... every time and the overall frequency of infections decreased. General rules don't apply to every patient (and I would think it would be obvious, but a sinus infection is, in fact, an infection, and antibiotics will help).

      October 3, 2013 at 17:59 | Report abuse |
    • .

      Ah Valentijn, at least your budget for birth control has gone to zero. Good luck with that mucus. Try snorting some Grey Goose: should clear you right up. Pet it in the neti pot.

      October 3, 2013 at 18:27 | Report abuse |
    • cnnreader

      sounds like you have allergies. if it lasts more than 7 days...it is probably allergies...

      October 4, 2013 at 14:29 | Report abuse |
    • Jenni Simonis

      Many sinus infections are caused by a virus, which would not be helped with an antibiotic.

      However, when it last and lasts, something should be done. I would recommend getting your doctor to refer you to an ENT (ear, nose, throat doctor). I had an ongoing sinus infection for nearly a year. I finally switched doctors. The very first visit he already had me scheduled for a CT scan and a referral to an ENT doctor. The CT showed the infection, that I have a severely deviated septum, and a bone spur. The septum and spur were causing the infections to happen over and over. It would start as allergies, but then some of the mucus would get trapped and then become infected. So I would get sick over and over.

      You may need a strong dose of antibiotics along with a steroid. I had to do two rounds in order to finally knock out my sinus infection. That was back in Feb/March and just now is my first sinus infection since then. Eventually I will have surgery and should cut way back on these infections.

      cnnreader –

      Allergies do not cause discolored mucus like that. Mucus from allergies should be clear.

      October 4, 2013 at 18:31 | Report abuse |
    • Terri P

      For the person with a five month sinus infection, keep trying to get help. I saw five ENTs who would not prescribe antibiotics (they said I had allergies).By the time I found a doc who would prescribe antibiotics, I had lost 40% of my hearing. PS, I eat a very healthy diet and exercise rigorously, and have tried the neti pot and many natural products. Antibiotics, 3 1/2 weeks worth by that time, were the only thing that worked. but the hearing loss has caused continuous problems with work and my life in general.

      October 4, 2013 at 21:06 | Report abuse |
    • Jenni Simonis

      Sorry to hear about the hearing problem. For me it's been my sense of taste. Huge issue when you're the one in the family who cooks all the meals. I have to get someone else to taste meals as I slowly add things like salt and pepper. Really sucks when you have a craving for something and can't satisfy it because the item doesn't taste right.

      October 4, 2013 at 23:29 | Report abuse |
    • MJ82

      As others have said, go see an ENT. Also, if you are on oral allergy medications research adverse reactions to them. At one point in time I literally was getting a sinus infection once a month. I was on antibiotics for half the month and when the sinus infection didn't clear up it developed into bronchitis. I was taking Singulair, and it turns out the Singulair was what was making me sick. I'd had CT scans, gone to see an ENT, was about to start allergy shots, etc. when I stopped taking all my medicines for a couple weeks in the winter. I was fine during those weeks, but when I started taking them again I was back to being sick. I did some research and by process of elimination I realized it was the Singulair. I stopped taking it and my problems went away.

      October 5, 2013 at 13:21 | Report abuse |
    • Mom

      Try mucinex and drink lots of water.

      October 5, 2013 at 17:47 | Report abuse |
    • Scott

      My gf who is a nurse explained mucus to me this way: if it's yellow and thick it could be a bacterial infection; maybe use antibiotics. If your mucus is white, it's a viral infection; don't use antibiotics. This is not 100% but a baseline but fairly close to how she diagnosis patients. I never receive antibiotics for a sinus infection because it's not needed and the infection will run its course.

      October 7, 2013 at 16:17 | Report abuse |
  3. ryan

    I work in an urgent care as a nurse and honestly the doctors shouldn't take the blame for this, I have witnessed numerous times patients coming in and demanding an antibiotic for an illness they have had that started that morning. Our society expects doctors to waive their magic wand and give them a pill that will make them feel better that night. If they don't get it then they will call and complain that the doctor did not treat them and demand to speak with a superviser. there is only so much providers can take from people. Please people do the providers a favor and let them practice. If they don't feel you need one then don't compalin, follow the instructions they give you and please don't diagnosis yourself with something from webmd. 🙂

    October 3, 2013 at 14:21 | Report abuse | Reply
    • sbradner88

      Agreed! I am a nurse in a Emergency Room and if we do not fix a patient they complain and give us bad reviews which now affects our payments from the government. Secondly, if a patient returns for the same illness within 30 days, medicare is starting to not pay for treatments so Dr's are expected to fix the problem the first time.

      October 4, 2013 at 00:39 | Report abuse |
    • CJ

      I bet some of the blame for people wanting a quick fix can go back to employers who are unwilling to give employees the time off they need when they get sick, too, so they want to feel better as quickly as possible. Not saying that makes it right at all, especially when there's no evidence the antibiotic would actually help, but I can understand the motivation behind someone who's in that position. People are so afraid of losing their jobs today they'll do almost anything to avoid missing work, or to prove they're missing work for valid reasons.

      October 6, 2013 at 17:28 | Report abuse |
    • Fran

      How many hospital-acquired infections are really the result of bacteria mutating due to antibiotic use? Also, I agree, doctors prescribe to protect themselves.

      October 8, 2013 at 12:18 | Report abuse |
  4. Scott Chancey

    Candida is a fungus, specifically a yeast, not a bacterium.

    October 3, 2013 at 14:34 | Report abuse | Reply
  5. Laura

    C. diff. nearly took my life nearly 14 years ago. I took antibiotics for what I thought was a sinus infection, as I had done many times before that. I was then sick with a C. Diff. infection for 8 months (relapsed 3 times), lost almost half my body weight and barely made it through. Since then, I have taken antibiotics 3 times in nearly 14 years. People, you DON'T NEED antibiotics for every sniffle, sore throat and cough. My immune system is stronger than ever! When I do take antibiotics, the milder ones work for me now – a far contrast to the old me who demanded the strong antibiotics because I swore up and down that MY infection was worse than most people's. And, it wasn't my doctor's fault. I thought I knew what I needed. I was so ignorant and misinformed. I learned the hard way.

    October 3, 2013 at 17:50 | Report abuse | Reply
    • Daniela

      I had acne and doctors shoved mountains of antibiotics at me to try to cure it. One day, I got MRSA, then spent the next 8 months trying to fight it. I developed a secondary infection along the way which almost killed me. The doctors could have admitted me to a hospital and removed the fluid pocket at any time, but instead chose to throw antibiotic after antibiotic at me. I even had to have intravenous therapy for three weeks.

      If they would have just operated, removed the fluid, and did wound care, my immune system would not be in shambles now.

      October 5, 2013 at 15:36 | Report abuse |
    • Scott

      @Daniela; my skin doc did the same thing to me in my 20s. He prescribed a nasty antibiotic which is rarely given out anymore and I can't remember the name. I had to change my life over this type; don't eat two hours before taking it or don't eat one hour after taking, etc. And it made me nauseous. Hated it but it helped to cure my breakouts. I gotta say that I never got sick in the four years I took it. LOL.

      October 7, 2013 at 16:21 | Report abuse |
  6. Waida Liu Godfrey

    So in order not to be blamed for "over-prescribing" antibiotics, you the patients just have to grunt & bear it until the laboratory result comes back. Or in the case of no throat culture taken, the doctor will treat you for a more serious illness if you don't get well on your own. Nip it in the bud!

    October 3, 2013 at 18:23 | Report abuse | Reply
    • .

      Waida, you are under the mistaken belief that antibiotics will help at best and do nothing at worst. Antibiotics have side effects and some people have carefully balanced bacterial flora inside them. Kill some and the others take off. Your sore throat will get better all by itself. Your cold or flu will get better all by itself. A cut will heal all by itself. Be a man and just ride it out.

      October 3, 2013 at 18:40 | Report abuse |
    • K

      "So in order not to be blamed for "over-prescribing" antibiotics, you the patients just have to grunt & bear it until the laboratory result comes back."
      Yes. Exactly. That's precisely how medicine has always been practiced. I don't know how they do it in your state, but that's still how it's done here. How will they even know WHAT antibiotic to prescribe until the results come back?

      October 4, 2013 at 10:40 | Report abuse |
  7. MIJohn

    First, just because a disease is viral doesn't automatically mean antibiotics are a bad idea. There is something called secondary or opportunistic infection. Infections that don't occur in a healthy person but can happen when the immune system is busy dealing with a viral infection. Antibiotics are prescribed in the cases of viral or fungal infections to prevent that secondary infection from settling in. And since it takes several days for most drugs to reach the necessary concentration where the pathogen will be its best to start as soon as possible instead of waiting.

    Second,the single biggest contributor to anti-biotic resistance isn't the meat industry. One of the FDA's jobs is to make sure that the concentration of any antibiotic in meat slated for consumption falls within acceptable limits. To say nothing of the law that states that antibiotics can only be given to an animal intended for slaughter if an set amount of time is observed between the final dose and being shipped for slaughter. That time by the way is based on the half-life of the drug and is such that when an animal getting the medication would end up in the slaughter house the amount in their body is miniscule. Plus the vast majority of pathogens animals can carry that are treated with antibiotics can not be transmitted to humans and the ones that can lack a resistant strain even after decades of being treated with the same antibiotics.

    The real factor is antibiotic resistant is people who get a disease, are prescribed antibiotics, then instead of continuing to follow the directions on the label stop taking the drug when they feel better. You see drug-resistance in bacteria is not like the drug tolerance you are assuming is the same thing. Tolerance is when the body needs more of a particular substance to get the same effect due to cells becoming desensitized through exposure. Drug resistance is the ability of some bacteria to either consume the antibiotic (ie the enzyme penicillinase) or simply not being affected (changing certain proteins that the antibiotic targets for similar ones with different structures, etc). What that means is that if someone got a near-lethal dose of antibiotic or was on one for decades they would have no more chance of the strain developing resistance than someone who just started. What gives rise to resistant strains is when someone stops taking their medication when they feel fine but before the directions say to. At that point the level of antibiotic in their body declines below the threshold to remain effective and the population of bacteria increases. Then the resistant strains, which normally the immune system deals with while the antibiotic kills off the non-resistant strains, starts breeding like mad and maybe even sharing its DNA with non-resistant bacteria. A situation that doesn't happen when people take the medication as prescribed because a proper dose is done such that it remains active until the population of bacteria is well below the critical amount for a sustainable population.

    So if you want to make sure you aren't contributing to the problem of antibiotic-resistant pathogens, FOLLOW THE DAMN DIRECTIONS! Even if you feel good, if the bottle says until gone then take them on the regime written down until gone. Don't second-guess, don't say "well I don't need these anymore" – just follow the bleeding direction. If in doubt, call your doctor first and then listen. I've lost count of how many times I've seen a patient for a cough that came back and when I ask their owner if they gave all the antibiotics they say no. Guess what people? The infection didn't come back – because you failed to follow the directions it never left.

    October 3, 2013 at 19:13 | Report abuse | Reply
    • ES71

      Exactly. They should fix the routine use antibiotics in farm animals day in and day out, instead of fighting with sick humans who actually need them just a couple times a year.
      I think there is more damage from animals that get them 365 days a year vs. a human taking them for 10 days.

      October 4, 2013 at 11:24 | Report abuse |
    • Wendy Wilson

      To say that Antibiotics are not a bad idea, even for a virus, is why people get into worse shape than they might've been if the dr had just waited! I have severe allergies to two major classes of antibiotics. I Dont Want Antibiotics, unless there is a clear reason for them, because I don't want to have to fight off a resistant strain of infection. As a teacher aide, I caught a cold from a boy at school, which set off a severe asthma attack. Ending up in the ER, and having a bunch of lab work, nebulizer, and xray, a nurse slipped in some IV antibiotic right after the saline bag. I questioned them about it, because this all started from a cold.
      "Oh, well, they think you have pneumonia." Huh??
      I've had pneumonia. I did NOT feel all sick and feverish during this asthma attack like I did then.
      I was really disapppointed, and miffed, at this blanket ordering of antibiotics for a virus. Prednisone, Duoneb, and O2, would've helped tide me over till they KNEW what they were dealing with exactly.

      October 18, 2016 at 14:23 | Report abuse |
  8. OvernOut

    I thought the whole antibiotics-for-a-sore-throat thing was started by the sudden death of Muppets creator Jim Henson. It was widely reported at the time that he died from untreated strep, and that he might have survived if he had only seen a doctor for antibiotics when the illness first appeared. I noticed people getting antibiotics more after that and household cleaning products started becoming "anti-bacterial". I don't recall that being the case before Henson's demise.

    October 3, 2013 at 19:33 | Report abuse | Reply
  9. wadej420

    world wide march against monsanto oct 12th!!!!!!!!!!! everywhere!!!

    October 3, 2013 at 20:11 | Report abuse | Reply
  10. Esteban


    October 3, 2013 at 22:29 | Report abuse | Reply
  11. EdL

    When I have a medical problem I see my doctor for guidance. If he prescribes an antibiotic for me, this is what I will take. I will not second guess him, if I did not trust his medical advice I would find another doctor who I would trust.

    October 3, 2013 at 23:30 | Report abuse | Reply
    • ARgo

      Spoken like a true Frenchman!

      October 4, 2013 at 00:48 | Report abuse |
  12. Portland tony

    Well I've been hearing about drug resistant infections being caused by the overprescribing of antibiotics for years. Who am I to argue with a person who has years of college followed by years of medical school about what friggin' medicine I should be taking for a short term illness that keeps me from making a living!

    October 3, 2013 at 23:56 | Report abuse | Reply
    • CM

      I always question my treatment plan if I am uncomfortable with it. Here's an example: awhile ago I went to the doctor and had a staph infection. They drained it and gave me antibiotics and pain pills. I read the label on the antibiotics very carefully. A week later, I woke up with the feeling that something was wrong. My skin felt tight, my throat itched, and I had a fever. Those were all symptoms of a reaction to my antibiotic, so I went back to the same doctor I had seen before. I saw a different doctor in the practice, who diagnosed me with strep without even looking in my throat. I told her I did not think it was strep, as my throat did not hurt, and I was on antibiotics that probably would have cleared up any infection I had. She insisted; I demanded a strep test. It was negative, but she still insisted it was strep and gave me a prescription for different antibiotics and a sample of liquid Vicodin for when my throat started to hurt. I left there, came home, and took a bath to try to make the weird feeling on my skin go away. When I stood up out of the water, my entire body was covered in hives. I called a different doctor to go in, and the doctor rushed and gave me shots and all this medicine and told me that if not treated immediately the reaction I had could turn into the terrible thing that causes the layers of your skin to separate. Instead of antibiotics and Vicodin, I ended up on strong steroids and antihistamines, as well as medicine to counter the side-effects of those medicines. The point it: Always question your doctor if you you think he or she is wrong!

      October 5, 2013 at 06:01 | Report abuse |
  13. Doug

    My kids, 8 and 7, drink liquefied veggies/fruit daily and are more or less gluten-free. Extremely little processed food, a really healthy diet. They have never really been sick – they get the bugs that make the rounds at school but pass them within HOURS. If I get stuck with one, I'm down, or at least affected for 8-12 days usually. I spent my youth on antibiotics. I feel permanently weakened immune system from them 🙁

    October 4, 2013 at 00:47 | Report abuse | Reply
    • K

      Oh please, lady. We don't have wheat or sugar in our house and we still get sick, just like everyone else. Kids have a faster metabolism and breeze through things that adults can take days getting over. It has nothing to do with diet. It has to do with age. My little rat would bring home every stupid public school disease he could find (and that's with him only taking one extra-curricular because he was homeschooled. And I guess that makes ME more holistic than YOU. And wasn't that your point? You're superior to everyone else because your kids eat vegetables?). He'd spike a fever, be bedridden the first day, totally fine the next. I'd catch it and feel like crap for 2 weeks. Can't wait until I'm a senior citizen and really feel that aging effect during cold and flu season.

      October 4, 2013 at 10:45 | Report abuse |
    • Howie

      SO sick of the anti-wheat freaks. News flash – unless you actually have celiac disease (extremely rare), gluten is not in any way harmful to a human. We process it quite well and it is good for us. This is proven scientific fact, but don't let that bother you any.

      October 7, 2013 at 13:51 | Report abuse |
    • Scott

      @Howie; LOL thank you brutha. I am tired of this useless rant myself. All I hear is how bad gluten is for me but my body is fully capable of utilizing gluten because my body can. The same for milk. However I'll eat it if it's ordered in a group party such as pizza.

      October 7, 2013 at 16:32 | Report abuse |
  14. ent

    some of these abx will have a secondary effect of reducing inflammation and thus will make people with viral inflammation feel better, this erronosly (sp) leads people to think that they need the abx the next time they have a sore throat or what they attribiute to the sinsues With a sinus infection of 5 mos you need to see a specialist (ENT) who can help decide if prolonged abx is needed or if it is time to consider imaging, directed culture, etc. with sinus infxn it is important to remember that abx are just part of the issue and you alos need to open up the sinuses with gentle decongestants (check with md first especially if you have high blood pressure) and help the the nose help it self with saline sprays, save the neti rinses for maintenance ,not acute infections. chronic sinus infection (longer than 12 weeks) are not always helped with abx and the right provider should be able to help come up with a plan to help

    October 4, 2013 at 08:07 | Report abuse | Reply
  15. EC

    I've spoke to my physician about why doctors over overprescribed antibiotics and she said it is a business. Doctors want to make their patients satisfied and if the patient thinks an antibiotic will help them it's hard to change their mind. Some doctors say 'well if I don't give it to her, she'll go find another doctor who will." As healthcare providers we need to step up and educate our patients while treating them with proper care.

    October 4, 2013 at 09:36 | Report abuse | Reply
  16. ES71

    > that prescriptions of antibiotics for sore throat and acute bronchitis are far more common than they should be

    It is the case of doctors telling us not to believe our own lying eyes.
    I know that antibiotics are the only thing that cure bronchitis in my case.
    I finally tired of having to fight with doctors for it ( especially when I am sick) and I simply smuggled whole bunch of antibiotcis from overseas where they can be bought without prescription.
    Now I dont' even need to go to the doctor – a win win!

    October 4, 2013 at 11:20 | Report abuse | Reply
    • Howie

      Have you heard of the placebo effect? That is what is making you feel better, certainly not the anti-biotics. Bronchitis is a viral infection – abx have no effect whatsoever on virus'

      October 7, 2013 at 13:53 | Report abuse |
  17. us_1776

    And now some doctors are actually under-prescribing antibiotics when they should be prescribing them.

    The pendulum for some has swung too far the other way.


    October 4, 2013 at 11:37 | Report abuse | Reply
  18. Bob C.

    People get antibiotics because they can't afford to take a few days off work to get better. They need to do anything they can to feel better right away. Even if it might not work, they have to try.

    The most accurate tests are cultures, but they always take 2-5 days to get results. Not many people can literally afford to wait that long.

    October 4, 2013 at 11:41 | Report abuse | Reply
  19. wrm

    Under-prescribing seems to be a bigger issue where I sit. They are trying to ride out staph infections here, rolling the dice that they will resolve on their own. Got turned away from Nurse Ratchet following a shoulder surgery where one port was obviously infected. By the time I came around on the last visit I had already grabbed a supply of augmentin to get out in front of it and Ratchet blew her top, as if some guard mentality drone has special insight. She got the doctor down to read me the riot act and he just shook his head and said he would've done the same thing I did, precluding the need for more drastic measures or a stronger antibiotic, which for me would have likely kept me on the toilet for a week.

    October 4, 2013 at 14:20 | Report abuse | Reply
  20. Kris

    Antibiotics are over-prescribed because a) it makes a load of money for the medical industry; b) people demand doctors give them something to make them better; c) few people (doctors, patients) will take the time required to determine exactly what type of illness it is (sinus infection, cold, strep, et al) – it's easier to prescribe and be done with it; 4) sick people get better, which happens regardless of taking an antibiotic or not, and will credit antibiotics as the "cure".

    October 4, 2013 at 16:09 | Report abuse | Reply
    • Jenni Simonis

      And some of it is the placebo effect – people get the medicine, they take it, and they feel better because they got a medicine. Not that the medicine made them better, but because they had something to take.

      I don't like taking antibiotics unless I absolutely have to. As I got older I became allergic to both penicillin and sulfa based drugs. That accounts for most forms of antibiotics. If I take the remaining ones too much they could become ineffective and then I'd be in trouble.

      October 4, 2013 at 18:35 | Report abuse |
  21. Jenni Simonis

    It may be a pain to wait, but I am glad that my doctor always does a strep test before prescribing anything. Then I know that I'm getting an antibiotic because I need it, not because the doctor wanted to take a shortcut or because I demanded it.

    October 4, 2013 at 18:33 | Report abuse | Reply
  22. Just say no to antibiotics

    I avoid antibiotics unless I absolutely need them.

    I had a sore throat and went to the doctor's office and was told that it was not strep, that it was a viral infection. I was told to gargle with hydrogen peroxide. It worked fine and the soreness was almost completely gone by the next day. So now when I get a sore throat, I try the hydrogen peroxide first and it works most of the time. It also works for most ear aches.

    Save the antibiotics for when you really need it because it can really be a life saver.

    The government is finally cracking down on antibiotic usage in animals. New antibiotics are not being developed fast enough to replace the ones that are becoming useless. Some strains of bacteria are totally resistant and they will kill you if you get them.

    October 4, 2013 at 22:30 | Report abuse | Reply
  23. stephanievandagriff

    Sometimes antibiotics are necessary. "The Effects of Lyme Disease" http://www.flickr.com/photos/kaiwestphotography/sets/72157633961673773/

    October 5, 2013 at 04:07 | Report abuse | Reply
  24. rick

    It would be nice if the article explained how antibiotics work. My mother is a retired nurse, and she was always trying to give me antibiotics for everything. Even she didn't get it. For those you that don't know, it is real simple.
    Antibiotics attack bacteria, not viruses. Antibiotics are 100% useless when used against a viral infection. Worse, they kill off good bacteria in your gut, and can cause digestion issues. When you have the flu, a cold, or anything else that is viral in nature- don't take antibiotics. If your doctor prescribes them, ask him or her why they would be effective for a viral infection. If they can't answer, don't take them.

    October 5, 2013 at 13:50 | Report abuse | Reply
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    Don't chuck the 'cillin so fast, or that dental wound might turn into a black, weeping abscess.....

    October 6, 2013 at 08:07 | Report abuse | Reply
  26. richard

    It takes 30 sec to write Abx Rx. It takes 2-3 minutes to explain why not giving Abx.
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    Risk management/ malpractice concerns add to Abx use. Lots of malpractice for NOT giving Abx, rare if gave Abx.
    Instant gratification outweighs "it will runs it,s course. It,s America...

    October 7, 2013 at 07:03 | Report abuse | Reply
  27. AmyT

    The public schools around here demand proof that kids are on antibiotics if they have a sore throat or if they have viral or allergic pink eye etc and the kids can't go back to school until the kids are on antibiotics for 24 hours. But if I don't get antibiotics so my kids can't go to school the school is constantly calling me saying I will be in trouble if I don't send them to school. So yeah my kids get antibiotics they shouldn't until schools change their rules.

    October 7, 2013 at 09:26 | Report abuse | Reply
    • Wendy Wilson

      I know, schools don't get it. either. Or with allergies/coughing. One teacher (I subbed for her aide) asked me to have the office call parents for a little girl that kept coughing. Office said parents knew she was coughing (she had cough-variant asthma), she wasn't feverish, incomfortable, or sick otherwise, and they wanted her to be at school. Teacher somehow got them to come get her. They were miffed. I can't say I blame them a bit.

      October 18, 2016 at 14:51 | Report abuse |
  28. Sarah

    I try to never take medicine - particularly pain meds - unless I absolutely need them. (My great-grandmother raised me to grit through minor inconveniences now in my youth, so that I can actually enjoy pain medications when I will really need them in my old age.) However, every other year I get bronchitis, and I keep it for months on end until I get an antibiotic – it simply does not go away on its own. Antibiotic clears it up 100% of the time, usually within 2 weeks.

    Now, my problem with doctors who prescribe antiobiotics is that they ALWAYS want to send me to go get some weirdly named, 'targeted' antibiotic with no generic that costs me a couple hundred dollars that i don't have, when I explicitly ask for something as common as amoxicillin (which I've found kills the infection WITHOUT the horrible side affects of these 'targeted' antibiotics). I know I'm not a doctor, but if I know something works from experience, why are you going to try to prescribe me stronger and more expensive meds?

    October 7, 2013 at 10:12 | Report abuse | Reply
  29. Goodhope

    Everyone please be aware that Cipro, Levaquin, and other Fluoroquinolones carry a black box warning from the FDA. These antibiotics are dangerous and cause crippling tendonitis and peripheral neuropathy, among other injuries. Yet doctors prescribe them frequently, especially for urinary tract or prostate infections, without even trying safer antibiotics first.

    October 7, 2013 at 13:47 | Report abuse | Reply
  30. Scott

    One particular things that I do that helps me as a preventative is I gargle with regular Listerine. I also floss three times a day and brush three times a day but the Listerine really helps me. It cuts down on whatever is living in my mouth and I know that it helps me to cut down on getting a cold, etc or helping to stop it early. Before bed I do a very thorough back-throat gargle and real deep for about 30 seconds. I burn my throat with that stuff and I hardly get sick.

    October 7, 2013 at 16:25 | Report abuse | Reply
  31. Fran

    Blame the trial lawyers. Doctors prescribe to "cover themselves." Also, don't forget that if workers are afraid to call out sick and stay home to rest.

    October 8, 2013 at 12:15 | Report abuse | Reply
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  33. Robert

    I think one reason that doctors prescribe so many antibiotics is due to the insurance companies. Rather than do any imaging that would require more money from your insurance, insurance companies are mandating that a person go through a course of antibiotics before they approve certain imaging procedures that would confirm or rule out certain types of infections. For instance, if someone has a "possible" chronic sinus infection, the insurance company would rather the patient go through a month of antibiotics than get to the bottom of the problem. This is pure greed. Antibiotics are cheaper but not the answer if there is no infection. Antibiotics can ruin your gut if taken even for short periods of time much less long term. Antibiotics should only be taken after a doctor CONFIRMS that one has an infection. This is done by ordering different tests, such as Imaging and LABs (depending on the type of infection). Some infections will only show up in the blood tests and not in imaging. The bottom line is this. Get to the root of the problem first, then treat it with the proper medicine and only if needed. Sometimes our body can do this on its own. But usually when we are going to the doctor for something, it has passed this stage and needs prompt diagnosis and resolution by a Doctor. Insurance companies needs to stop their "death panel like ways". It is killing people.

    February 10, 2014 at 18:58 | Report abuse | Reply
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  36. cindywhitinggmailcom

    Thank you for your article on the overprescribing of antibiotics. As mentioned in your article, many patients expect and sometimes even demand antibiotics to treat symptoms that do not require antibiotics. Rather than giving in to the pressure to prescribe, health care providers need to spend more time educating patients about antibiotic resistance and the potential side effects of taking unnecessary antibiotics. As part of that discussion, health care providers can suggest specific symptomatic relief options that are available to the patient that will help them be more comfortable until their symptoms resolve. The Centers for Disease Control and Prevention website is a great resource for information about antibiotic use. There is a link on the website that goes to a video that discusses when antibiotics are needed, how to use them appropriately, and how to stop antibiotic resistance. http://www.cdc.gov/features/getsmart/

    May 17, 2016 at 20:39 | Report abuse | Reply
    • dwhill83

      I agree with you that there is a huge need to educate our patients better when it comes to overprescribing antibiotics. There are other things that can be done as well. I recently read an article that emphasizes the need to educate our patients about better hand hygiene as well. We focus so much on what we do as providers to prevent the spread of these super bugs and other diseases that we overlook the fact that the patient is just as likely to spread them when they leave our facility. You can read more about this topic here – http://www.americanmobile.com/nursezone/nursing-news/superbugs-and-hand-hygiene-for-patients/



      May 18, 2016 at 00:34 | Report abuse |
    • Meridith

      I appreciate your comment and completely agree about patient education. To me, giving the patient what they think they want instead of empowering them with knowledge is really a disservice. Thank you for your comment!

      May 18, 2016 at 13:07 | Report abuse |
    • khart3

      I agree that it is very important to educate people about when we use antibiotics vs. when they are unnecessary. The World Health Organization (WHO) said that antibiotic resistance is one of the biggest risks to global health today. Antibiotic resistance can happen to anyone, but the rate is quickly increasing due to the inappropriate use of antibiotics. It is important that we reserve the use of antibiotics for when they are truly needed. The WHO also gives suggestions on how to prevent antibiotic resistance on their website: http://www.who.int/mediacentre/factsheets/antibiotic-resistance/en/.

      May 19, 2016 at 17:06 | Report abuse |
    • beckyras

      I think that public education is so important on antibiotic overuse. It seems that a major paradigm shift is needed in the general perception of the public in regard to the proper place for antibiotics.

      May 24, 2016 at 20:58 | Report abuse |
  37. lizharding801

    I agree with Cindy. Even though it takes more time, and is often the harder choice, health care providers should not prescribe antibiotics unless clearly indicated.

    May 23, 2016 at 13:08 | Report abuse | Reply
  38. Stacy

    Why are doctors not testing if patients have an infection and what kind before prescribing antibiotics? My Grandmother had a UTI for over 2 years before being sent to a specialist, who tested her for what kind of infection and bacteria was causing it. Then she was prescribed the right antibiotic! She spent thousands on Doc visits and antibiotics that the doctors were just guessing may work! Emagine all the damage that has happened to her body. All because Doctors were just guessing and not testing first, to see which bug needed which antibiotic!

    January 31, 2017 at 16:07 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.