Are antibiotics really being over-prescribed?

ANTIBIOTICS
ARE THEY REALLY BEING OVER-PRESCRIBED?

You would almost have had to have been living under a rock not to realize that over-prescription of ANTIBIOTICS has become an epidemic of the Western World.  Do doctors realize the scope of this problem?  Yes and no.  Although medical researchers are screaming their heads off about this issue, studies say that the average practicing physician has changed their antibiotic prescription habits very little, is not taking time to educate patients about this issue, and succumbs to patient pressure to give them the drugs they think they should have.

What are doctors saying about antibiotics?

Although you have probably heard something about the antibiotic problem in America, you likely know little about it.  Even though Medicine's "Academia" has declared this issue a full-blown crisis, it does not seem to be filtering down to the practicing doctors ---- the doctors in the trenches who see patients day in and day out (HERE).  Why is this?  I am not completely sure, but I have a feeling that it comes down to two things

• TRAINING:  Unless your doctor graduated from medical school very recently, he / she will still see antibiotics as a "savior" of sorts.

• CONFRONTATION:  Even when doctors realize they should not be prescribing antibiotics, they do because patients "demand" them.  It's easier to write the script than take a few minutes to educate a patient.  By writing the script, the doctor does not have to confront the patient in any meaningful manner. 

Poster from England's National Health Service

In hospitals, 190 million doses of antibiotics are administered each day. Among non-hospitalized patients, more than 133 million courses of antibiotics are prescribed by doctors each year. It is estimated that 50 percent of these latter prescriptions are unnecessary since they are being prescribed for colds, coughs and other viral infections.  Taken directly from the website of the American College of Physicians (Internal Medicine).


On their website, world-famous Mayo Clinic lists health problems that are almost always viral in nature ---- but are commonly treated with antibiotics.  Which health problems that you or your family face are almost always viral? 

• Most Ear Infections (HERE)
  
• Colds
  
• Influenza (FLU)
  
• Most Coughs (HERE)
  
• Most Sore Throats
• Bronchitis
• Stomach Flu

At a recent seminar, Dr. Stuart B. Levy of Tufts University School of Medicine in Boston, Massachusetts reported that “more than 80% of the physicians present admitted to having written antibiotic prescriptions on demand against their better judgment.”  This is a real problem because the website of the American College of Physicians (Internal Medicine) says that, "The only true way to know if your cold or sickness is a bacterial infection is for your physician to test it. If you have a sore throat your physician should take a throat culture test..... There is no sure way of knowing whether a cold or sickness is a bacterial infection without a test." 

The problem is that "the problem" is not really getting smaller ---- it's getting bigger.  Even though doctors are at least paying lip service to this issue, mis-prescribed antibiotics are beyond out of control.  A recent study by the Center for Disease Control said that, "In the United States, 1.7 million hospital-associated [hospital-caused]infections, from all types of microorganisms, including bacteria, combined, cause or contribute to 99,000 deaths each year."  But prescription habits for antibiotics do not seem to be changing.  Oh, and by the way, this problem is contributing to the largely American phenomenon of DYSBIOSIS ----- a problem that is at the root of untold amounts of suffering and ill health.  Is Dysbiosis a brand new problem?  Of course not!  The problem of mis-prescribing antibiotics has been around for decades.

• "It is clear that there is no role for antibiotics in the management of simple upper respiratory infection and bronchitis. This statement is data-based, uncontroversial, and supported by every expert panel and management guideline.  Why then do physicians continue to prescribe antibiotics – of wider and wider spectrum – for these syndromes? The scope of the problem is immense. A large 1997 survey indicated that antibiotics were prescribed for 52 percent of patients with URIs and 66 percent of patients with bronchitis.  This practice did not vary by geographical area, physician specialty or patient sociodemographic or insurance status. These data are consistent with other U.S. surveys and with data collected in other industrialized countries. Antibiotics unnecessarily prescribed for URIs and bronchitis represent 31 percent of total antibiotic prescriptions in the U.S."    Miriam Rabkin (M.D.  M.P.H.), Medical House Staff Training Program in Internal Medicine for the Department of Medicine - Columbia University Medical Center. 

• "Even in the Netherlands there is an over-prescribing of antibiotics; about 50% of the antibiotic prescriptions for acute RT episodes are not in accordance with Dutch national guidelines." Dr. Hugg van Duijn of the Julius Center for Health Sciences and Primary Care from the University Medical Center Utrecht, The Netherlands.  The paper was published in the medical journal BMC Family Practice.

• French "Watchdog" group UFC-Que Choisir found 52 per cent of doctors automatically prescribed antibiotics for medical cases that did not merit them.  January 2011 Report.

• Doctors are over-prescribing antibiotics for common sinus infections and related conditions, possibly in the false belief they may help in cases where symptoms are protracted, researchers reported recently.  Bacteria can cause sinus infections, but viruses are a more likely culprit.  "This is why antibiotics seldom work on sinus infections," reported researchers in the prestigious medical journal Lancet.  Yet doctors still dole out the drugs more than they should. In the United States, for instance, 80 percent of sinus patients are prescribed an antibiotic while the proportion ranges from 72 percent to 92 percent in Europe.  Analysis of nine previous studies described a false belief that antibiotics may help if symptoms are long-lasting.  "What we can show is that the length of symptoms reported by the patient does not reliably distinguish between viral and bacterial infection.  Antibiotics are not justified even if a patient reports symptoms for longer than 7-10 days," the researchers said.

• Pediatricians in the United States write more than 10 million unnecessary antibiotic prescriptions every year for conditions such as the flu and asthma reported the journal Pediatrics.  In total, doctors prescribed an antibiotic at one in every five visits, with most dispensed for children with respiratory ailments such as sinus infections and pneumonia.  Almost one-quarter of all antibiotic prescriptions were given to children with respiratory conditions that do not call for antibiotics, such as bronchitis, the flu, asthma and allergies.  Half of all the antibiotics prescribed were "broad-spectrum" drugs, which act against a wide range of bacteria -- killing more of the good bacteria in the bodies as well and perhaps setting the child up for more serious infections with antibiotic-resistant bacteria later on.  "We think of antibiotics as being wholly beneficial, but they are not very specific, they hit everything in your body. By making our microbes that are supposed to be with us disappear, we can be causing other health problems we don't know about," said the researchers.  My opinion is that this is essentially "Sugar Coating" the epidemic of Dysbiosis. 

Overuse of antibiotics is a huge problem because it destroys gut function.  To understand why Gut function is so critical to good health, you have to realize that 80% of your entire immune system is found in your gut. Go back and re-read my short series on Gut Function.
PART I
PART II
PART III

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