ANTIBIOTICS: DOCTORS SAY THEY ARE OVERPRESCRIBED

Antibiotics are overprescribed and increasingly ineffective against drug-resistant bacterial infections, medical experts say.

Once hailed as miracle drugs, they have ironically fostered a new menace as diseases have become resistant to the medicines.

"There is no question in my mind that antibiotics are overprescribed," said Dr. Jim Hoffman, a Cape Girardeau pediatrician.

In 1995, the Centers for Disease Control said 50 percent of 110 million prescriptions for antibiotics written each year may be inappropriate for the illness being treated.

More than 70 percent of babies are prescribed an antibiotic in the first 200 days of life, researchers at the University of Iowa said.

Ear infections topped the list of ailments for which antibiotics were prescribed, the researchers said.

Parents often pressure doctors to prescribe antibiotics for their sick children.

"They think antibiotics are good for everything," said Dr. Robb Hicks, a Cape Girardeau general practitioner.

"You do feel pressure to give antibiotics, but you just have to sit down and educate your parents that in this situation they are not needed," said Hoffman.

Antibiotics can combat bacterial infections, but they don't work on viruses.

"Many of the upper respiratory illnesses are viral and antibiotics don't help," said Hoffman.

Hicks said most colds in children younger than 5 are caused by viruses.

But in many cases, it is unclear if a patient has a viral or a bacterial infection.

Hicks said he and other doctors often see children who don't have full-fledged ear infections but who show signs of getting such infections.

In those cases, it makes sense to prescribe an antibiotic, he said. "A lot of times we use amoxicillin, which is a very inexpensive and basic medicine," said Hicks.

Hoffman said doctors are inclined to prescribe antibiotics when children have had a cold for four or five days and the nasal discharge is a little pussy.

Hicks operates a walk-in health clinic. He said parents often bring their sick children to him after their regular doctors refused to prescribe antibiotics.

Hicks said he tries to explain to parents why antibiotics won't work in a particular case.

"A lot of people simply need something to control their symptoms and then let the infection run its course," Hicks said.

But parents don't like to hear that.

Hoffman said, "The natural inclination is to want to make your child better and do it quickly because he is your kid."

Antibiotics became popular with the introduction of penicillin in the 1940s.

Before that, bacterial infections that are commonly cured today, such as pneumonia and strep throat, could be crippling and even fatal.

Hundreds of antibiotics have been developed in the last 50 years.

Some medical experts view the drug-resistant bacteria as a potential time bomb.

"The reality is we are going to come upon a time when we will not have the antibiotic we need to kill a particular organism," Hicks said.

Until recently, if one drug became useless, there was always another that doctors could use.

But the supply of new drugs has slowed. Drug companies in the late 1980s started developing other medicines, believing that there was no need for new antibiotics, Hoffman said.

The drug companies are beginning to develop new antibiotics again, but such medicines won't be on the market for at least a couple of years, Hoffman said.

Hicks said doctors must be selective in the kinds of antibiotics they prescribe.

"We need to use the less expensive, less complex, less sophisticated antibiotics for simpler infections, and save the newer, more expensive, sophisticated medicines for more serious infection," he said.

"That way," said Hicks, "we can delay antibiotic resistance as much as possible."

Prescriptions by the numbers

-- Obstetricians and gynecologists write 2.65 million antibiotic prescriptions every week.

-- Internists write 1.4 million antibiotic prescriptions a week.

-- Pediatricians and family physicians prescribe more than $500 million worth of antibiotics annually for the treatment of ear infections in children.

-- Antibiotic prescriptions to young children have risen 51 percent in the past 15 years.

-- Some 40 to 60 percent of all antibiotics in this country are unnecessarily prescribed.

-- In 1983, more than 51 percent of the more than 3 million patients who saw doctors for treatment of the common cold were given a prescription for an antibiotic even though the drugs do nothing for such viral infections.

Source: The book, "Beyond Antibiotics, Healthier Options for Families"