American children are being prescribed antibiotics too frequently, often for viral respiratory infections for which the drugs provide no benefits, researchers reported in the journal Pediatrics.
The authors add that the use of broad spectrum antibiotics has been on the rise for several years, which encourages antibiotic resistance. More than 10 million ineffective and unnecessary antibiotic prescriptions are written for children by doctors in the U.S. each year, the authors wrote.
Antibiotic resistance, sometimes termed drug resistance, refers to the ability of micro-organisms like bacteria to withstand an antibacterial that used to kill them. The gradual overuse of erythromycin and penicillin has been linked to the progression of antibacterial resistance since the 1950s.
In his study, Adam Hersh of the University of Utah in Salt Lake City and his team set out to determine levels of antibiotic prescribing in the U.S. in ambulatory pediatrics. They also wanted to determine what factors are linked to the prescribing of broad-spectrum antibiotics to children.
They gathered data from the National Ambulatory and National Hospital Ambulatory Medical Care Surveys, dated 2006 to 2008. The authors wrote that the surveys represent ambulatory care visits nationally. They calculated the percentage of patients who were prescribed antibiotics and how they were diagnosed.
The authors found that 21 per cent of pediatric ambulatory visits result in an antibiotic prescription and 50 per cent of these were broad-spectrum antibiotics. In 70 per cent of cases where both antibiotics and broad spectrum antibiotics were prescribed, the patient had a respiratory condition. In 23 per cent of respiratory visits where antibiotics were prescribed, they should not have been — nationally, a total of more than10 million unnecessary antibiotic prescriptions.
In an abstract in the journal, the authors concluded: “Broad-spectrum antibiotic prescribing in ambulatory pediatrics is extremely common and frequently inappropriate. These findings can inform the development and implementation of antibiotic stewardship efforts in ambulatory care toward the most important geographic regions, diagnostic conditions, and patient populations.”
A study released Monday contributes to mounting evidence that suggests newer types of birth control pills carry increased risks of blood clotting and may not be safe for certain groups of women.
The latest study looked at 330,000 Israeli women and found a strong likelihood that those who used birth control pills with the hormone drospirenone, which is used in brand names like Yaz and Yasmin, were more likely than other pill users to develop blood clots called venous thromboembolisms.
Although the numbers are relatively small, only six per 10,000 users, the risks were 43 per cent higher with drospirenone-containing pills, compared with older, second- and third-generation pills, which becomes more than 10 per 10,000 or 0.1 per cent.
Dr. Susan Solymoss of McGill University in Montreal, who wrote an editorial published with the study in the Canadian Medical Association Journal, reminded readers that:
“It’s important to remember that all oral contraceptives are associated with a risk of blood clots.”
Women shouldn’t panic or quit their contraceptives, but should have a discussion with their doctor and think about their circumstances, lifestyle and medical and family history, she said.
Dr. Naomi Gronich, who led the new study, agreed with Solymoss, saying that age is another factor. Gronich, of the Technion-Israel Institute of Technology in Haifa, told Reuters Health that blood clot risk gradually increased after the age of 25. Not taking birth control pills is an option for any woman but Solymoss pointed out that other contraceptives might not be as effective at preventing pregnancy.
“And pregnancy is a bigger risk for blood clots,” she said.
For every 10,000 women who become pregnant in a year, about 20 will develop venous blood clots. That compares with the rate of six women per 10,000 among pill users overall and three in 10,000 women who are not on the pill.
Bayer HealthCare, the manufacturer of Yaz, Yasmin, Beyaz and Safyral, said it was still reviewing the new study from Israel and could not comment on it. Bayer also looked to its own post-marketing studies that have failed to turn up a heightened clot risk with drospirenone contraceptives versus older ones.
