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The American College of Physicians and the United States Centers for Disease Control and Prevention (CDC) has issued new guidelines for prescribing antibiotics for acute respiratory tract infections (ARTIs) in adults. Acute infections of this sort include uncomplicated bronchitis, sinusitis, sore throat and the common cold.
Experts estimate that up to 50% of antibiotic prescriptions for these common complaints are unwarranted or unnecessary, according to unpublished CDC data. All told, we’re wasting about $3 billion annually on these prescriptions. Given that antibiotics are the drugs most often associated with adverse drug reactions—leading to one-fifth of all adverse drug reaction visits to the nation’s Emergency departments—experts think it’s time to rein in runaway prescribing for these ailments.
There’s more than wasted healthcare dollars at stake, too. ”Inappropriate use of antibiotics for ARTIs is an important factor contributing to the spread of antibiotic-resistant infections, which is a public health threat," said ACP President Wayne J. Riley, MD, MPH, MBA, MACP. "Reducing overuse of antibiotics for ARTIs in adults is a clinical priority and a High Value Care way to improve quality of care, lower health care costs, and slow and/or prevent the continued rise in antibiotic resistance.”
As most people know, the common cold is caused by a number of viruses, none of which can be treated with antibiotics. It and other ARTIs should be treated symptomatically in most cases. Therapies include over-the-counter pain relievers, such as ibuprofen, aspirin or acetaminophen, and plenty of fluids and rest. Only if infection with group A streptococcus is suspected—and confirmed—should antibiotics be prescribed.
Aaron M. Harris, MD, MPH; Lauri A. Hicks, DO; Amir Qaseem, MD, PhD, MHA. Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention. Annals of Internal Medicine, January 2016 DOI: 10.7326/M15-1840