American doctors are prescribing fewer antibiotics to children with respiratory diseases than they did in 1997, a survey by the US Centers for Disease Control and Prevention (CDC) indicates.
The survey determined that the number of prescriptions for antibiotics written for children under 15 who had middle-ear infections, colds, bronchitis, sinusitis and sore throats had declined by 12% between 1989 and 1998. In 1989–90, 737 antibiotic prescriptions were written for every 1000 office visits, compared with 647 per 1000 in 1997–98. Data from 225 000 patients and 22 500 physicians, gathered in the National Ambulatory Medical Care Survey, were analysed.
“We are extremely encouraged by the reductions in antibiotic prescribing for pediatric respiratory infections,” said Richard Besser, medical epidemiologist at the National Center for Infectious Diseases.
Besser directs a 6-year-old CDC campaign that promotes the appropriate use of antibiotics (www.cdc.gov/drugresistance/). Each year, more than 100 million prescriptions for antibiotics are written for nonhospitalized Americans, and it is estimated that about half are written for colds, coughs and other viral infections that don't respond to antibiotics. The CDC recently released a draft public health action plan to combat antimicrobial resistance.
In Canada, the National Information Program on Antibiotics (NIPA), a coalition of 8 health organizations, reports a decline in prevalence of 2 of the more common drug-resistant superbugs. In 1998 more than 14% of cases of Streptococcus pneumoniae infection were resistant to penicillin.
However, swabs taken from patients across the country over the past 2 years indicate the rate has fallen to about 10%. Similarly, in 1996 about 40% of cases of Hemophilus influenzae infection involved antibiotic resistance. That has dropped to 25%.
Recently, the CMA joined forces with NIPA in an effort to raise awareness about this serious public health threat. A national poll of physicians by NIPA revealed that 79% had changed their prescribing practices for treating respiratory symptoms during the past 3 years. A survey of the public found that 55% of Canadians are now less likely to ask for a prescription for antibiotics to treat a cold or flu than they were 3 years ago. —