Do Doctors Misdiagnose Children With Sore Throats?
Do Doctors Misdiagnose Children With Sore Throats?
The overprescribing of antibiotics has been a source of legitimate worry for quite some time. A recent study conducted by experts from Brigham and Women's Hospital (BWH) and Children's Hospital Boston revealed that antibiotics were recommended in 53% of cases of sore throat in children, even though there are clear guidelines requesting previous testing.
Given the actual incidence of strep throat in children with a sore throat, which range from 15 to 36 percent, this amounts to a substantial over-prescribing of medication. Almost half of the prescriptions were also filled without first conducting a test. The Journal of the American Medical Association published the full report of this study on November 9, 2005.
Streptococcal pharyngitis, more often known as strep throat, is the leading cause of antibiotic-induced sore throats. The American Academy of Pediatrics and the Centers for Disease Control and Prevention are among the many prominent health groups that advocate for the use of a common "strep" test before administering antibiotics.
Bacteria that Resist Antibiotics
"This study demonstrates that children with sore throat are frequently given unnecessary antibiotics," says main author Jeffrey A. Linder, MD, MPH, an internist at BWH.
"This overprescribing of antibiotics could be easily remedied by following known guidelines, which include doing a simple, inexpensive strep test," according to him.
"This is critical for not just children but all patients," he says, "as unnecessary prescription of antibiotics can lead to a variety of issues, including increased costs, the potential development of antibiotic-resistant bacteria, and adverse drug effects."
Children with sore throats who visited doctors' offices, hospitals' outpatient departments, or emergency rooms between 1995 and 2003 were the subjects of the study. The children's ages ranged from three to seventeen.
The researchers found that antibiotics were provided in 53% of the approximately 7.3 million episodes of sore throat during this time period.
Estimates show that only around 15% to 36% of children who experience a sore throat truly have the strep throat bacterium. However, prior testing was only conducted on 53% of the patients who were prescribed antibiotics.
Testing Is Not Used Enough
An promising trend emerged over the eight-year study period: doctors administered antibiotics less frequently. While 66% of cases were prescribed antibiotics in 1995, that number dropped to 54% in 2003.
Even so, as Dr. Linder notes, the prescription of antibiotics that are not recommended—which accounted for 27% of all antibiotic prescriptions—did not reduce. Penicillin, amoxicillin, erythromycin, and first-generation cephalosporins are the antibiotics that are most commonly prescribed to treat strep throat.
"Strep testing is underused, and physicians should be ordering this important diagnostic test before prescribing antibiotics to kids with sore throat," Dr. Linder points out.
"Instead of writing a prescription, physicians should order a test and make sure they are treating kids' symptoms by offering a pain medication like acetaminophen or ibuprofen," according to him.
Daily News Central, 2005. All rights reserved.
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