Misuse of Antibiotics for Sore Throat

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Misuse of Antibiotics for Sore Throat

Sore throat is the second-most common symptomatic reason for seeking medical care, with cough being the most common. Approximately 76% of adults who visit a primary care physician because of a sore throat are given an antibiotic, even though viruses that are not affected by antibiotics are the primary cause for upper-respiratory-tract infections.

The only common cause of a sore throat that can be managed with antibiotics is the bacterial group A beta-hemolytic streptococci (GABHS), which is present in throat cultures in only 5-17% of adults.

In this study, the authors examined data from 355,354 patient visits in the National Ambulatory Medical Care Survey (NAMCS) from 1989 to 1999, which resulted in a sample of 2,244 patient visits for sore throat. They calculated rates of prescriptions for patients with sore throats, as well as the different antibiotics prescribed by physicians. The results showed that when antibiotics were prescribed, they were frequently unnecessary, and often the patients were given unrecommended antibiotics. The recommended antibiotics were only prescribed in 23% of visits. Recommended antibiotic use also decreased from 32% of cases in 1989 to 11% in 1999, while unrecommended antibiotic prescriptions increased.

There are two main concerns for the overuse of antibiotics, according to the authors: monetary costs and the development of strains of bacteria that are resistant to antibiotics. They conclude, "Efforts should be continued to encourage appropriate antibiotic use by both patients and physicians."

Linder JA, Stafford RS. Antibiotic treatment of adults with sore throat by community primary care physicians: A national survey, 1989-1999. Journal of the American Medical Association, September 12, 2001:286(10), pp. 1181-1186.