Doctors 'fuelling antibiotic resistance'

Some antibiotics have lost their ability to treat disease

US doctors are prescribing antibiotics freely to people with sore throats - even though for most the treatment is completely inappropriate.

The research was published on the same day that the World Health Organization issued a warning that humans are building up dangerous levels of resistance to modern antibiotics that could leave them vulnerable to killer diseases.

The world health body said tuberculosis strains in several countries had become resistant to two of the most effective drugs and some antimalarial medicines had become practically useless as parasites adapted their defences.

Unless we act to protect these medical miracles, we could be heading for a post-antibiotic age

Gro Harlem Brundtland

WHO Director Gro Harlem Brundtland said: "Antibiotics were one of the most significant discoveries of the 20th century.

"Unless we act to protect these medical miracles, we could be heading for a post-antibiotic age in which many medical and surgical advances could be undermined by the risk of incurable infection."

Study findings

Results from the US National Ambulatory Medical Care Survey, conducted between 1989 and 1999, showed that 73% of patients with sore throats received antibiotic prescriptions.

However, antibiotics are only helpful in about 10% of cases where sore throats are caused by bacterial "strep" infection.

Most sore throats are due to viruses, against which antibiotics have no effect.

Lead researcher Dr Jeffrey Linder, from Massachusetts General Hospital, said: "If you go and see your doctor for an upper respiratory infection, including a sore throat, nine times out of 10 you should not be given an antibiotic."

The researchers said part of the problem was that doctors were pressurised into prescribing antibiotics by expectant patients.

They warned that as well as helping develop drug resistance, excessive antibiotic use could place patients at risk of allergic reactions.

Newer drugs

Many of the prescriptions were for newer, "broad-spectrum" drugs which cost as much as 20 to 40 times more than the two antibiotics recommended for strep throat, penicillin and erythromycin.

Researcher Dr Randall Stafford said: "Patients who previously received antibiotics for viral conditions, probably received no benefit from those prescriptions.

"On their next episode of sore throat, they may feel they need a newer antibiotic because of their unsatisfying earlier experience."

The researchers said a small decline in the number of prescriptions was seen in 1999, which may indicate that doctors and patients were becoming more aware of the dangers of overusing antibiotics.

The research was published in the Journal of the American Medical Association.