CDC, doctors group issue advice for not taking antibiotics

Most respiratory tract infections are not affected by antibiotics, leading experts to suggest patients are counseled on easing symptoms as illnesses run their course.

By Stephen Feller

WASHINGTON, Jan. 19 (UPI) -- Acute respiratory tract infections bring adults to the doctor's office the most often, and antibiotics are the most common treatment. A physician's group and the Centers for Disease Control and Prevention contend, however, that antibiotics are generally not necessary for the infections.

The American College of Physicians and CDC issued a set of recommendations for the treatment of ARTIs -- which include acute uncomplicated bronchitis, pharyngitis, rhinosinusitis, and the common cold -- moving away from antibiotics because they do not treat the conditions.


Previous research has shown about half of all antibiotic prescriptions are unnecessary, and many antibiotics are losing their efficacy because of unnecessary use.

While many patients expect antibiotics, including for the common cold, physicians are recommended to help patients treat symptoms and educate them on the lack of effect the drugs have on ARTIs and similar infections.

"Inappropriate use of antibiotics for ARTIs is an important factor contributing to the spread of antibiotic-resistant infections, which is a public health threat," Dr. Wayne J. Riley, president of the ACP, said in a press release. "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."


The new guidelines on antibiotic use, published in the Annals of Internal Medicine, set out four health situations that, based on a review of previous studies and medical data, either do not require antibiotic use or recommend their use with specific infections.

For the common cold, doctors are recommended not to prescribe antibiotics and focus on treating symptoms, with additional treatments considered if symptoms continue for more than two weeks or get worse, although antibiotics still would not help.

Patients with uncomplicated bronchitis should not receive antibiotics unless they have pneumonia, and the experts suggest testing should not be done either unless the patient is thought to have pneumonia. Symptoms should be treated with cough suppressants, expectorants, antihistamines and decongestants.

Patients with sore throats also should not receive antibiotics because they do not improve symptoms, and a similar recommendation was made for patients with uncomplicated sinus infections, which generally improve with supportive care.

In nearly all cases, the guidelines significantly suggest counseling patients on the lack of an effect antibiotics have on these illnesses and that other treatments can be more effective at easing symptoms.

"Although it is everyone's responsibility to use antibiotics appropriately, providers have the power to control prescriptions," researchers wrote in the guidelines. "Reducing inappropriate antibiotic prescribing will improve quality of care, decrease health care costs, and preserve the effectiveness of antibiotics."


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