Doctors Over-Prescribe Antibiotics, Raising Risk of Superbugs

By Frances Schwartzkopff

July 26 (Bloomberg) -- Programs to limit the use of antibiotics have failed to keep family doctors from over- prescribing the pills, raising the risk that drug-resistant germs such as MRSA will develop, a study found.

Doctors from 1998 to 2001 prescribed antibiotics for more than 80 percent of sinus and lower respiratory tract infections, and more than 60 percent of cases of sore throats and ear infections, according to a study of the U.K.'s general practice research database, published today in the Journal of Antimicrobial Chemotherapy. The database, the largest of its kind worldwide, contains medical records for 3.4 million patients.

Antibiotics target bacteria and don't help respiratory tract infections caused by viruses. Drug misuse leads to mutations in bacteria that make them immune to common therapies. Efforts to educate physicians and the public have decreased antibiotic use in the U.K. by 20 percent in the past decade, and more progress is needed, said Richard Wise, chairman of the U.K. government's Specialist Advisory Committee on Antimicrobial Resistance.

``Doctors are human; they tend to bend to the will of the patient,'' Wise said in a telephone interview July 25. ``It's all understandable but in the next five to seven years, we're going to have simple infections that won't be treatable by common antibiotics.''

Methicillin-resistant staphylococcus aureus, or MRSA, and other so-called superbugs are among the biggest threats to public health, leading to longer illnesses, sometimes death, and higher treatment costs, including hospitalization, according to the World Health Organization. The Geneva-based agency laid out a strategy for limiting poor prescribing practices in 2001.

MRSA Infections

Forty-six out of every 1,000 patients in U.S. health-care facilities have MRSA, as much as 11 times higher than previous estimates, and the superbug is spreading into communities, the U.S. Association for Professionals in Infection and Epidemiology said in June. MRSA can cause pneumonia and skin, bloodstream and urinary tract infections.

Already tuberculosis, gonorrhea, malaria and childhood ear infections are hard to treat because the microbes have become drug-resistant, according to the U.S. Food and Drug Administration. About 70 percent of bacteria that cause hospital infections are resistant to common medicines.

Drug-resistant bugs are the biggest health-care threat in Europe, each year killing as many as 50,000 people, the European Center for Disease Prevention and Control said last month. Countries such as France, where antibiotic use is high, also had the most drug-resistant bugs, according to a 2005 study of health records in 26 European countries published in The Lancet.

Coughs and Colds

One-third of the public still believes antibiotics work against coughs and colds, Cliodna McNulty, head of the primary care unit of the Gloucestershire Royal Hospital-based Health Protection Agency, said in another study, on public attitudes, in a special supplement on drug-resistance in the Journal of Antimicrobial Chemotherapy.

``Many doctors believe that by giving an antibiotic, they might be doing some good or at least covering the possibility of a missed diagnosis of significant bacterial disease,'' Douglas Fleming, a member of a U.K. government advisory group on drug- resistant microbes, said in another article. There's ``little thought given to the possibility of doing harm.''

Still, superbugs, once mostly a hospital problem, now are hitting communities, while most big drug companies have virtually stopped research into new antibiotics to which bacteria aren't immune in favor of medicines to treat chronic, life-long diseases, Wise said.

``We're going to have to use more expensive, potentially more toxic medicines,'' Wise said. ``We may have to fall back on drugs abandoned 50 years ago.''

To contact the reporter on this story: Frances Schwartzkopff in Copenhagen at fschwartzkop@bloomberg.net

Last Updated: July 25, 2007 19:01 EDT

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