Doctors overprescribing antibiotics for sore throats

Doctors treating sore throats are overprescribing antibiotics to more than a million U.S. children annually, unnecessarily driving up health costs, promoting the rise of drug-resistant bugs, and exposing children to unnecessary drugs and their side effects.

That’s the conclusion of a new study of national treatment data by faculty at Harvard Medical School and the Harvard School of Public Health.

The study used information from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey to examine the treatment of 4,158 cases of sore throat in children age 3 to 17 from 1995 to 2003.

Though the study showed a decline in antibiotic prescribing over the study period, from 66 percent of cases to 54 percent, researchers concluded that many children are still receiving unnecessary antibiotics each year.

That’s because most sore throats in children are caused by respiratory viruses like those that cause colds and cannot be treated with antibiotics. The only common cause of sore throats that can effectively be treated with antibiotics is the group A beta-hemolytic streptococci bacteria, familiar to parents as the cause of strep throat.

Health officials estimate that just between 15 percent and 36 percent of children with sore throats actually have strep. If the study’s findings hold true for the entire population, that means between 1.3 million and 2.8 million children with sore throats are getting antibiotics unnecessarily each year. Jeffrey Linder, instructor of medicine at Harvard Medical School and Brigham and Women’s Hospital, and the study’s lead author, said the unnecessary prescriptions drive up health care costs and can increase the likelihood of the development of drug-resistant bacteria. Most troubling though, he said, is that doctors are exposing these children to the possible side effects of drugs unnecessarily.

“Probably the most important issue, in my mind, is exposing kids unnecessarily to a medicine,” Linder said. “Kids are exposed to all the risks of the medicine with no possible benefit.”