Sham: Antibiotic Use in Children Can Be Dangerous if Over-Prescribed

Recent research shows that the over-prescription of antibiotics for children can actually lead to resistant infections. Antibiotic-resistant bacteria are becoming more and more of a problem worldwide, and the practice of daily, prophylactic antibiotic use may be behind the problem in small children.

As an example, urinary tract infections (UTI's) are extremely common in children. The use of prophylactic antibiotics for this condition, which involves daily administration of antibiotics after an initial infection, is associated with an increased risk of resistant infections, according to a study in the July 11 issue of JAMA. Here is more detail from this research:

Estimates of cumulative incidence of UTI in children younger than 6 years (3 percent - 7 percent in girls, 1 percent - 2 percent in boys) suggest that 70,000 to 180,000 of the annual U.S. birth cohort will have experienced a UTI by age 6. Daily antibiotic treatment is recommended in an attempt to destroy or suppress the growth of microorganisms present in recurrent UTIs.

Patrick H. Conway, M.D., M.Sc., of the University of Pennsylvania Robert Wood Johnson Clinical Scholars Program, Philadelphia, and colleagues conducted a study to identify risk factors for recurrent UTI and estimate the effectiveness and possibility of resistance of antimicrobials in preventing recurrent UTI. Patients in the study were from a Children’s Hospital of Philadelphia supported network of 27 primary care pediatric practices in urban, suburban, and semi-rural areas spanning three states, with children ages birth through 6 years, who were diagnosed with first UTI between July 2001 and May 2006.

Among 74,974 children in the network, 611 had a first UTI and 83 had a recurrent UTI. The researchers found that exposure to prophylactic antibiotics significantly increased the likelihood of resistant infections (7.5 times increased risk).

“Given … previous findings and the unfavorable risk/benefit ratio demonstrated by the current study, we think it is prudent for clinicians to discuss the risks and unclear benefits of prophylaxis with families as they make family-centered decisions about whether to start prophylactic [antibiotics] or to closely monitor a child without prescribing [antibiotic] prophylaxis after a first UTI,” the authors write.

Many scientists believe it is critical that we learn to live with less indiscriminate use of antibiotics, as the issue of resistant bacteria is real and can cause huge complications to society down the road. An article from the FDA which explains the process of antibiotic resistance in bacteria is linked to the headline of today's post.

Dave