CHICAGO -- A group of pediatricians concerned about the overuse of antibiotics found that withholding the drugs from children with respiratory infections did not hurt them.
The researchers said that many doctors, pressured by parents and schools, may prescribe antibiotics for virtually all respiratory infections. But the overuse of antibiotics has also led to antibiotic-resistant bacteria, a serious long-term problem.In a yearlong study of 383 children, doctors from a pediatric practice in the Rochester, N.Y., area administered what they called "judicious antibiotic use" in patients with colds and other respiratory infections. The results were published in the April issue of Pediatrics, the journal of the American Academy of Pediatrics.
Since most respiratory infections are caused by viruses and antibiotics work only against bacteria, antibiotics were given only to children with infections presumed or shown by lab tests to be caused by bacteria.
Infants and children through age 12 were studied. About one-quarter of the children received antibiotics, while the rest did not.
The doctors then compared the frequency of return office visits within a month of the initial visit. Just 29 percent of the untreated group showed up for an unscheduled visit for additional treatment, compared with 44 percent of the antibiotic-treated youngsters.
The study's authors, led by Dr. Michael Pichichero, wrote that while some doctors will prescribe antibiotics for nearly all patients with respiratory infections, "there is, however, no scientific rationale for such antibiotic use."
A survey from the Centers for Disease Control and Prevention published in the December issue of Pediatrics showed that 86 percent of pediatricians surveyed in Georgia routinely prescribed antibiotics for bronchitis, even though such use is rarely justified; and 42 percent prescribed them for the common cold, which is caused by viruses.
Many do so out of concern that a patient with an untreated virus is vulnerable to a secondary bacterial infection, according to Pichichero.
Dr. Tina Tan, an infectious-disease specialist at Children's Memorial Hospital in Chicago who was not involved in the New York study, said it makes an important point that "the better part of valor here is to err more on the conservative side and not prescribe an antibiotic for an upper respiratory tract infection."
The study may encourage doctors "to really think about what they're diagnosing and what should and should not be treated," Tan said.
On the Net: CDC site on antibiotics: www.cdc.gov/ncidod/ar/
Mayo Clinic page on antibiotics: mayohealth.org/mayo/9710/htm/antibiot.htm