Study: Doctors Overusing 'Super Drugs'

Doctors are being more careful about prescribing antibiotics for common ailments, but when they do, they are turning too often to powerful new superdrugs, a new study says.

The overuse of broad-spectrum antibiotics for minor infections poses a serious health threat because it could speed bacterial resistance to valuable and potentially lifesaving drugs, according to a study in Tuesday's edition of the Annals of Internal Medicine.
The study reviewed the prescribing behavior of physicians from 1991-99.

"The good news is antibiotics are being used less often in situations where they are not needed, such as to treat the common cold and mild bronchitis," said Dr. Michael Steinman of the University of California at San Francisco, lead author of the study. "The troubling news is that when doctors do turn to an antibiotic they are increasingly turning to broad-spectrum agents."

Antibiotics only fight bacteria and have no effect on viruses. Doctors, however, often prescribe them for children with viral earaches or for adults with colds - because patients demand them or because there's not a clear diagnosis and antibiotics kill many different bugs.

As a result, germs are becoming increasingly impervious to antibiotics. Many common infections no longer are treatable with old standbys like penicillin, and some have become untreatable by every antibiotic on the market. Any time antibiotics are used, survivor germs can emerge stronger and spread.

Researchers looked at data from the Centers for Disease Control and Prevention from outpatient clinics and found that the number of antibiotic prescriptions doctors wrote decreased roughly 17 percent from 1991 to 1999. However, prescriptions of broad-spectrum antibiotics roughly doubled - from 24 percent to 48 percent for adults and from 24 percent to 40 percent for children.

The study also says that broad-spectrum drugs were increasingly being used for bronchitis and respiratory infections over the decade, though they're almost always useless against those bugs.

It's good news that we're seeing a downward trend in antibiotics prescriptions," said Dr. Richard E. Besser of the CDC, author of an editorial on antibiotics accompanying the article. "But we still have a long way to go and unless we continue to reinforce the appropriate prescribing behavior, the gains we're achieving will be lost."

The broad-spectrum agents might get preference over old standbys because some doctors mistakenly perceive the newer drugs work better - or because they're still under patents and therefore heavily advertised and distributed to doctors in free samples, Besser said.

Steinman noted that there is also a financial drawback to using the more powerful drugs: A typical seven-day course of broad-spectrum antibiotics can cost around $50 compared to the cost of a narrow-spectrum course of around $5.

The government estimates that half of the 100 million antibiotic prescriptions written in physician offices each year are unnecessary. Starting next year, the Food and Drug Administration is requiring antibiotics to bear warnings about the dangers of their overuse.

"Broad-spectrum antibiotics are very valuable commodities," Steinman said. "The more we use them now for conditions that do not require them, the more quickly bacteria will become resist to these drugs - and when we really do need them for serious and complicated conditions, they won't be there anymore."

By Joann Loviglio