Fri, Mar 05, 2004 - Page 7 News List

Doctors, patients curbing their use of antibiotics

NY TIMES NEWS SERVICE , ATLANTA

Doctors and patients are beginning to curb their use of antibiotics as a result of educational programs, federal health officials said Wednesday.

The inappropriate use of antibiotics has led illness-causing microbes to become resistant to such drugs. Antibiotic resistance is a major public health problem throughout the world, and is particularly common among the bacteria that cause ear and respiratory infections.

"We are making progress" against the problem in this country, said Dr. Richard E. Besser, an epidemiologist at the Centers for Disease Control and Prevention.

"When we look at the prescribing data across the nation, we see dramatic declines in prescriptions to children and to adults," Besser said.

Antibiotics are most often prescribed for an inner ear infection known as otitis media, Besser said. From 1980 through 1982, antibiotic prescribing rates for children by office-based physicians increased 48 percent.

In 1999 and 2000, doctors in this country wrote an average of 11 million antibiotic prescriptions for ear infections in children 15 and younger, a spokeswoman for the disease control centers said. But one study showed about a 25 percent reduction, largely among office-based doctors, in prescribing standard antibiotics for children's ear infections.

However, the study cautioned that increased prescribing of newer antibiotics might offset the reduction.

Further declines are likely after pediatric and family practice organizations issue new guidelines this spring that will encourage doctors to avoid prescribing antibiotics for ear infections in children, Besser said at the Fourth International Conference on Emerging Infections here.

The proposed guidelines, Besser said, emphasize the need for stricter criteria in diagnosing infections and in relieving the pain that makes many children with ear infections cranky. The guidelines also advise that not prescribing antibiotics for children is acceptable therapy. Experience in Europe shows that 80 percent of children get better without the drugs, Besser said.

The centers and other health organizations have been conducting educational programs aimed at correcting misconceptions among doctors and the public about antibiotic therapy.

A major problem, many doctors say, is that managed health care plans do not give doctors time to explain to patients why antibiotic therapy is not indicated. Under such circumstances, many doctors contend, pulling out a prescription pad is the easiest solution.

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