MD

2011-03-10

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'U' study reveals increase in prescriptions of antibiotics for children across the state

By Zach Bergson, Daily Staff Reporter
Published March 7, 2011

The next time you have a cold, you might want to stop yourself from reaching for a Z-Pak.

Antibiotics like the Zithromax Z-Pak are used too often in the state among children and cause health risks for young people, a recent University study found. Despite 15 years of educational campaigns by the Centers for Disease Control and Prevention, researchers found that antibiotic prescriptions pose more harm than good by causing antibiotic-resistant infections and a drain of health care money and resources.

According to the study conducted by the University-funded Center for Healthcare Research and Transformation, there was a 4.5-percent increase among children and a 9.3-percent decrease among adults who were prescribed antibiotics from 2007 to 2009. The study also found that five of the 10 most commonly prescribed antibiotics were “antibiotics of concern” — drugs like Zithromax and Augmentin — that treat many types of bacteria, but can create antibiotic resistance within patients if misused.

Blue Cross Blue Shield of Michigan — Michigan’s largest health care provider and a partner supporting the Center for Healthcare Research and Transformation — provided the data on adults and children analyzed in the study.

The study reports that antibiotics, while useful in fighting bacterial infections, do little to cure viral infections such as bronchitis and the common cold. In addition, “antibiotics of concern” or “broad spectrum antibiotics” are only intended to treat patients with infections who haven’t responded to other antibiotics, according to the study.

However, because antibiotics are commonly prescribed in Michigan and throughout the nation to treat the aforementioned illnesses, more than $20 billion in excess health care costs in the U.S. have been used as a consequence to treat prevalent antibiotic-resistant infections.

Despite these side effects, the study found that nearly half of the antibiotics prescribed in Michigan were classified as “broad spectrum antibiotics.”

A geographic analysis of Michigan found that children and adult prescription rates were higher in regions outside of Southeast Michigan, especially in regions in the Upper Peninsula, Northern areas in the Lower Peninsula and along the state’s Ohio border. The study points to differences in education as an explanation for this disparity.

Southeast Michigan may have a lower child prescription rate than other areas in the state because it has a higher concentration of pediatricians, who were specifically targeted by campaigns to reduce antibiotic overuse, according to the study.

Heather Holmstrom, a clinical lecturer in medicine at the University’s Medical School, said she feels most doctors, regardless of specialty, understand the risks and benefits when prescribing antibiotics. She said a doctor’s background and colleagues have a larger influence on how they prescribe antibiotics than his or her area of expertise.

“It’s not based on what specialty people are in, more their training and philosophy, and whether they have the support to do what they think is right or whether they have pressure to do something else,“ said Holmstrom, who wasn’t involved in the study.

The recession might have caused an increase in antibiotic prescriptions, Holmstrom added, because many unemployed people have been forced to change their health care plans.

“Because of the economy, people are getting care from lots of different providers and maybe don’t have the ability to get care from their usual family doctor,” she said.

Holmstrom added that alternative health care providers like clinics have difficulties denying patients who expect to be prescribed antibiotics because these doctors have weaker support systems in place.

To decrease antibiotic overuse, Holmstrom and the Center for Healthcare Research and Transformation recommended further public education about antibiotic misuse and alternatives to the drugs.

“Giving people resources to other types of care — for example, saline nasal irrigation works really well but is not commonly known,” Holmstrom said. “I think education about other ways that people can help themselves get better and stay away from antibiotics is a really important thing.”

In terms of further research on the subject, the center plans to look into why the rate of adults using antibiotics has decreased while use among children is up, according to Karen Stock, spokeswoman for the Center for Healthcare Research and Transformation.

But even with more education and research, Holmstrom said she thinks it will take a number of years to significantly alter people’s perceptions and use of antibiotics.

“For many, many years people were used to going to the doctor and getting a shot of penicillin when they sneezed twice, and I think it’s going to take a while to change people’s use,” Holmstrom said.