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Overprescribed Antibiotics Hurt One, Hurt All

Worst Pills, Best Pills Newsletter article June, 2013

It is often estimated that about half of all antibiotics prescribed in the U.S. are unnecessary, usually because they are prescribed for many viral illnesses, such as colds, that they cannot treat. A recent study from the U.S. Centers for Disease Control and Prevention (CDC) shows large, otherwise inexplicable variations in antibiotic prescriptions from state to state, only furthering the concern about this massive waste of money and endangerment of people’s health.

The number of...

It is often estimated that about half of all antibiotics prescribed in the U.S. are unnecessary, usually because they are prescribed for many viral illnesses, such as colds, that they cannot treat. A recent study from the U.S. Centers for Disease Control and Prevention (CDC) shows large, otherwise inexplicable variations in antibiotic prescriptions from state to state, only furthering the concern about this massive waste of money and endangerment of people’s health.

The number of total annual prescriptions of antibiotics is alarming: In 2010, the latest year for which such data are available, health care providers prescribed 258.0 million courses of antibiotics outside of the hospital alone. This translates to 833 prescriptions per 1,000 people. The number of prescriptions per person ranged from an average of 638 per 1,000 people in the West (and even lower in California, Oregon and Alaska) to an average of 936 per 1,000 people (50 percent higher than the West) in the South (and even higher in West Virginia, Kentucky and Tennessee).

Children up to age nine were prescribed almost one-fifth (18 percent) of the antibiotics in the country, which is considerably disproportionate to the fraction of the population they represent (13 percent). This age group has recently been the focus of intensive research on the overprescribing of antibiotics.

In addition to wasting billions of scarce health dollars on inappropriate antibiotics, such wanton overprescribing presents two types of serious dangers. The most obvious are adverse reactions. These may arguably be tolerable if the antibiotics were able to stop the infections, but in the absence of any possible benefit, the often serious side effects are unacceptable.

The other harm, affecting the patient as well as the public at large, is summed up in the first sentence of the CDC’s study: “Antibiotic use is an important factor in the spread of antibiotic resistance.” One of the greatest threats to public health is the growing number of types of bacteria that were once sensitive to commonly used antibiotics (such as penicillin or its derivatives) and are now resistant to more and more antibiotics.

When your doctor pulls out a pen to write a prescription for an antibiotic, you should ask him or her, especially if you are not feeling very sick: Do I really need this? And why?