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A WebMD/Medscape survey of doctors, nurse practitioners, and physician assistants found only 5% insisting they never prescribed antibiotics unless they are absolutely certain of the necessity.
What that means is that most practitioners give antibiotics to patients at least sometimes when they are unsure of the necessity. More troubling is that this is not a sometime thing for the vast majority; a third prescribe them more than 25% of the time.
Nor does it matter much what the prescriber’s specialty is. Those in emergency medicine admitted to prescribing antibiotics in the absence of medical certainty 24.4% of the time. Those in women’s health (17.6%) and pediatrics (18.6%) had the lowest, but still high, rates.
“These results underscore that antibiotic prescription for questionable need is a problem that occurs across all specialty types and knows no specialty boundaries,” says Brad Spellberg, MD, a recently appointed Professor of Medicine at the Keck School of Medicine at USC.
The 796 clinicians participating in the survey had numerous reasons for prescribing antibiotics, including for malpractice concerns and simply because the patient requested it.
Patients, too, were surveyed about antibiotics, with 23% reporting they asked for a prescription. Out of that group, 35% said they have never been told drugs weren’t necessary.
Although the clinicians and the patients in the study agreed that education about antibiotic effectiveness — or ineffectiveness — and bacterial resistance is helpful, only 53% of patients said they’ve had such conversations.
In an interview about the survey, Dr. Tom Frieden, Director of the Centers for Disease Control and Prevention (CDC), said, “We have seen that about one third, and maybe as much as one half, of all antibiotic prescriptions in this country are either unnecessary or are inappropriately broad-spectrum.
“There is, quite frankly, far too much antibiotic use in this country today.”
“We have to emphasize that drug resistance is an enormous problem,” he said. “We talk about the pre-antibiotic era and the antibiotic era, and if we are not careful, we will be in a post-antibiotic era.”
