Kids with asthma, UTIs may be overprescribed antibiotics

Not too long ago (and perhaps a bit more now than is healthy), there was an attitude that preventative antibiotics were not harmful and a fine choice for treating possible infections.

Then we got nasties like MRSA out in the community (thanks, hypochondriacs!) Doctors have been beating the “please don’t overuse antibiotics” drum for quite some time now, and two new studies out of the University of California San Francisco indicate that antibiotic overuse is indeed a problem, perhaps particularly in children with asthma and urinary tract infections.

Data was gathered between 1998 and 2007 for both studies. Researchers contrasted outcomes when prescriptions were offered first versus when pediatricians spoke to parents about asthma attack prevention and other treatment options:

Of the 5,198 outpatient visits included in the analysis, antibiotics were prescribed during nearly one in six visits. The researchers estimate that this equates to about 1 million antibiotic prescriptions for kids with asthma in the United States each year.

The study also indicated that when pediatricians discussed best practices for treating asthma and preventing attacks during office visits, patients were less likely to receive antibiotic prescriptions. As a next step, the researchers emphasize the importance of encouraging more doctors to take the time to educate their patients about asthma in order to eliminate unwarranted prescriptions.

Additional study regarding whether antibiotics hold promise for reducing inflammation in patients afflicted with asthma is ongoing. Hillary Copp, MS, MD, lead author of one of the studies, commented on the importance of targeted antibiotic use in preventing bacterial resistance:

“It is always concerning when we see a rise in a particular antibiotic class, as this can create drug resistance through antibiotic selection pressures,” said Copp, who is an assistant professor of pediatric urology at UCSF. “It is okay to prescribe broad-spectrum antibiotics if a doctor thinks the clinical scenario warrants it. However, when this is done, a urine sample should be obtained so therapy can be tailored accordingly and patients can transition to a more narrow-spectrum drug based on the urine culture results.”

Both studies have been published in the June edition of the journal Pediatrics.