Antibiotics for back-to-school throat infections often not the best solution

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A Capital Health/University of Alberta pediatrician and researcher reminds parents that antibiotics are not a cure-all for every illness a child brings home from school.

“It is widely recognized that inappropriate use of antibiotics has been linked to an increased number of drug-resistant bacterial infections,” says Dr. Terry Klassen, Regional Program Clinical Director for Capital Health’s Child Health Program and Chair, Department of Pediatrics, University of Alberta. “This can cause serious problems, especially when we see resistance against very new, specialized antibiotics.”

Dr. Klassen recently co-authored two research papers published in the July 20 edition of Canadian Medical Association Journal. The papers point out that well-established guidelines for prescribing antibiotics are often ignored, in part because some parents demand that their children receive antibiotics, even for viral infections which do not respond to antibiotics.

Dr. Klassen’s group of researchers identified several important non-clinical factors that resulted in an inappropriate use of antibiotics. These factors include the physician’s country of training, the physician’s specialty, age of the child, and the child’s household income. The research group assessed the health records of 20,000 children to identify prescription trends from 1996 to 2000.

The study indicates that 45% of visits to a physician resulted in an antibiotic being wrongly prescribed to treat a viral respiratory tract infection (VRTI). Furthermore, 20% of those prescriptions were for ‘second-line’ antibiotics which are normally used to treat unusual or difficult bacterial infections.

Pediatricians and other specialists were more likely than general practitioners to prescribe antibiotics for VRTI. Physicians trained in Canada and the U.S. were 40% less likely to ignore prescribing criteria than physicians who trained elsewhere. As well, children who came from higher income families were more likely to receive antibiotics for viral infections.