Friday, October 19, 2007

Sham: Antibiotics Often Overprescribed in Respiratory Tract Infections

Doctors often believe that there is a protective effect in giving antibiotics against common respiratory tract infections. The assumption is that while antibiotics can not stop a common viral problem like the common cold, the antibiotics are assumed to be quite useful in preventing further infections, pneumonia, etc. A new editorial from the British Medical Journal states that for certain populations, this may be helpful, but in the great majority of cases these antibiotics are inappropriate. This study says that antibiotics are just not justified to reduce the risk of complications after upper respiratory tract infection, sore throat, or ear infection.

Most antibiotic use is in primary care, and most of it is for common respiratory tract infections. Guidelines exist against the routine use of antibiotics in patients with upper respiratory tract infection, sore throat, and ear infection, but do recommend them for pneumonia.

Although rates of antibiotic prescribing for acute respiratory infections has declined worldwide, antibiotics are still given to patients with respiratory infection, including over 90% of those with chest infection, 80% with ear infections, 60% with sore throat, and 47% with upper respiratory tract infections (statistics from England).

On the basis of the evidence in this BMJ study, there seems to be a substantial gap between evidence-based guidance and general practitioners’ prescribing behavior.

The authors identified 3.36 million episodes of respiratory tract infection recorded between 1991 and 2001 in the UK General Practice Research Database and determined whether complications were less common in people who were prescribed antibiotics than in those who were not. Serious complications were rare after upper respiratory tract infections, sore throat, and ear infection. Antibiotics reduced the risk, but in the statistical research it was discovered that over 4,000 courses were needed to prevent one complication.

In contrast, the risk of pneumonia after chest infection was high in elderly people, and was substantially reduced by antibiotic use. The number needed to treat to prevent one case of pneumonia was 39 for those aged 65 and over.

Based on this information, it seems unwise to use antibiotics on anyone but elderly people, or for those with severe lung infection possibly leading to pneumonia. For many, there are benefits to using an herbal treatment with a product like Kan Jang®. Kan Jang® was recently rated an "A" by National Standard, an organization of doctors which reviews alternative medicines, in the category of upper respiratory tract infection, beating out Zinc, Vitamin C,and Echinacea. It is a combination of Andrographis and Eleutherococcus, two herbs traditionally used for immune system support.


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