1 In 3 Antibiotics Prescribed In U.S. Are Unnecessary, Major Study Finds


Nearly a third of antibiotics prescribed in doctors’ offices, emergency rooms and hospital-based clinics in the United States are not needed, according to the most in-depth study yet to examine the use and misuse of these life-saving drugs.

The finding, which has implications for antibiotics’ diminished efficacy, translates to about 47 million unnecessary prescriptions given out each year across the country to children and adults. Most of these are for conditions that don’t respond to antibiotics, such as colds, sore throats, bronchitis, flu and other viral illnesses.

Although health officials have been warning for decades about the overuse of antibiotics and its contribution to the development of drug-resistant bacteria, the research from the Centers for Disease Control and Prevention and the Pew Charitable Trust is the first to quantify the depth of the problem.

“We’ve all been hearing, ‘This is a problem, this is problem,’ and we all understood the general concept that there is a lot of antibiotic use,” said David Hyun, a senior officer with Pew’s antibiotic resistance project and one of the authors of the report published Tuesday in JAMA. Pew also published a companion report using the same data.

“Why this study is so important: it actually provides concrete numbers,” Hyun said.

The study analyzed data for all antibiotic use in the three settings as collected from two major CDC surveys from 2010 to 2011. Antibiotic prescriptions written there represent the majority of dollars spent on antibiotics in health care in this country.

Among the key findings:

— About 13 percent of all outpatient visits in the United States — about 154 million visits annually — result in an antibiotic prescription.

— More than four in 10 (44 percent) of antibiotic prescriptions are written to treat patients with acute respiratory conditions, such as sinus infections, middle ear infections, sore throats, colds, bronchitis, asthma, allergies, flu, and pneumonia.

— Half of these prescriptions are unnecessary because many are for viral illnesses.

Doctors often wind up prescribing antibiotics because of pressure from patients or parents, said Katherine Fleming-Dutra, a CDC medical epidemiologist and report’s lead author.

“Clinicians are concerned about patient satisfaction and the patient demand for antibiotics,” she said. But the majority of individuals do trust their doctors to make the right diagnosis, and better communication by doctors about the dangers of antibiotic overuse can lead to more appropriate prescribing, she said.

An accompanying editorial in JAMA noted that the numbers provided in the report likely is an undercount because they don’t include the times antibiotics are given when patients talk to doctors’ offices over the telephone, or when patients seek medical care at urgent care clinics, retail pharmacies and dentists’ offices.

Also not included are prescriptions written by nurse practitioners and physician assistants.

The overuse of antibiotics has led to the frightening rise of drug-resistant superbugs in recent years. The CDC has warned that “nightmare bacteria” are increasingly resistant to even the strongest antibiotics, posing a growing threat to hospitals and nursing homes nationwide.

Last year, the White House announced an aggressive plan to combat antibiotic-resistant bacteria, which already cause an estimated 2 million illnesses and 23,000 deaths every year just in the United States. The administration set a target of reducing inappropriate antibiotic use in outpatient settings by half by 2020.

Based on the new report, this goal would be reached by cutting outpatient antibiotic use by 15 percent overall, which would result in approximately 23 million fewer antibiotics prescribed annually by 2020.

(c) 2016, The Washington Post · Lena H. Sun 



  1. Well, sometimes viral infections lead to secondary bacterial infections which might necessitate preemptive antibiotics. I had a first hand experience with the protocol obsessed hospital residents: my then six months old was hospitalized with a breathing difficulty caused by a pulmonary virus, albuterol was not working, the hospital “doctors” told us to basically tough it out for three days or so, meanwhile a week passed and the baby kept on getting worse to the point of elevated white cells and transfer to ICU, finally we had an outside doctor brought in who promptly prescribed xopenex instead of albuterol and antibiotics for the secondary bacterial infection, the baby got better immediately and we were out of the hospital in a day. Beware of doctors whose allegiance is to rules and protocols instead of well being of the patient.

      • The baby did not get better on his own. The fever kept on going higher, the oxygen level was low, and don’t forget elevated white cells count which means there is a bacterial infection. He was inches away from sepsys and organ failure. All we got from the hospital was an oxygen mask, albuterol(was supposed to clear the breathing passages but wasn’t doing the trick) and Tylenol. The hospital doctors had predicted the virus to be over in 3 days. Well, not only it wasn’t over in 3 days, but his condition kept on deteriorating to the point of ICU, over a week hospital stay with not only no improvement but consistent going worse. When we tried xopenex prescribed by our private pediatrician, he was able to breathe right away. So, no coincidence here. Later, we found out that a portion of population does not get relief from albuterol, xopenex usually works then. The hospital must have known that, yet was following the protocol required albuterol, would rather let the baby choke rather than try another drug. Regarding elevated white cells, keep in mind, it wasn’t supposed to happen at all with this virus, and the elevated white cell count doesn’t just go away in hours, which is what happened when we started antibiotics. So again, no coincidence here either. Please understand: the primary purpose of protocols is to save medical care resources, additionally to provide a doctor’s defense in case of malpractice lawsuit; the patient’s well being is the last priority. Don’t be a victim, always try to educate yourself when dealing with medical professionals. Try to get a doctor who still has the old fashioned morals of patient first. Don’t die because some bureaucratic jerk wants to save a few cents, and forces doctors to keep on prescribing a drug that doesn’t work in your particular case. Perhaps, it is a form of cynicism to be naive in a cynical world.

        • Don’t get me wrong. I was saying protocol still exists for a reason. Their are many accidents prevented due to protocal . Humans forget to follow rules thats where rigid protocol helps. But a second opinion is always the best. Two medical opinions are better than one. Its also good so another doctor can catch what the first missed.

  2. Why is it that only once did it happen that a doctor prescribed antibiotics for a viral infection?That was 35 years ago, and since then I’ve been to countless doctors, in different countries, and with my kids, and (except for that one occasion) they always told me it’s viral and therefore it wouldn’t be treated. I don’t think the doctors feel “pressured” to prescribe antibiotics, they just fall into the habit, like that one did. The others simply told me that it’s viral and we left it at that. Doctors who prescribe unnecessarily should be convicted of dangerous practice, harming individuals and the public. The facts have been out for decades, and now we are paying the price of those doctors stupidity/laziness/weakness and worse.

  3. The grievous problem of the development of drug-resistant bacteria discussed by this excellent article is just one of the many bad results of the inappropriate overuse of antibiotics. Another probably equally detrimental problem is that many people do have allergic sensitivities to certain antibiotics, especially the most well known one, Penicillin. The adverse reactions they experience can widely range from “only” a mild rash all the way to nausea or vomiting or dizziness or even inability to breathe! These much more serious problems are categorized as the severely dangerous situation of “anaphylactic shock” that, CHAS V’SHALOM, CAN BE DEADLY! (See http://www.webmd.com/allergies/guide/penicillin-allergy-topic-overview and see http://www.ncbi.nlm.nih.gov/pubmed/1576461 that states that, in just the U.S., around 500 people a year, Lo Alaynu, actually DIE in such reactions.)

  4. An adverse reaction to an antibiotic (or any drug) can happen even when even a small amount of the medication is ingested orally. When it is INJECTED into the patient — when it is usually given in a much larger amount and it is thus being placed directly into the bloodstream — the chance of a harmful reaction is understandably significantly greater. (See http://www.worldallergy.org/professional/allergic_diseases_center/anaphylaxis/anaphylaxissynopsis.php under the heading “Antibiotics and Other Drugs.”) Upon a visit to a general practitioner, he was explaining to me how doctors need to be very cautious when giving antibiotics. He was thus severely critical of those physicians who “enjoy” giving their patients injections: ” . . . and especially with some doctors who are ‘shot happy’!!”

  5. About six years ago, on September 19, 2010, at http://matzav.com/rabbi-leibel-gleiberman-zl/, Matzav reported the Petira of one of the top Talmidim of Yeshiva Chaim Berlin, Rabbi Chaim Yehuda Leib (Leibel) Gleiberman ZT’L. When I lived in Boro Park in the early 1980’s, I had been privileged to be a guest at many of his family’s Shabbos and Yom Tov Seudos. At one of those Seudos, the during some of the “table talk” chatting, they mentioned a family whom they knew where, Lo Alaynu, an antibiotic-caused-death had occurred. The son had, had a cold — it was (virtually) nothing! A minor common cold! He went to a doctor for some treatment, and the doctor gave him AN INJECTION of Penicillin, and, Lo Alaynu, he had the ultimate violent reaction. As he was being put into the ambulance, his last words (in Olam HaZeh) were exclaimed in Yiddish that he forgave everyone!

  6. The issue that antibiotics do not work on virus infections discussed by this excellent article is just one of many areas where antibiotics are not appropriate. Another probably equally important area where antibiotics are not appropriate is that even many bacteria infections can be very effectively cured by various NATURAL treatments. See the excellent presentation at http://www.myhealthwire.com/news/herbs-supplements/796, which lists 10 great foods that contain numerous crucial substances that fight harmful infections and strengthen a person’s immunity. B’Ezras HaShem, I will list the ten foods here, but please, look at that article itself, as it explains in detail the specific benefits of each item. The ten foods are: 1.) Garlic 2.) Honey 3.) Cabbage 4.) Grapefruit Seed Extract 5.) Raw Apple Cider Vinegar 6.) Extra Virgin Coconut Oil 7.) Echinacea 8.) Fermented Foods 9.) Colloidal Silver 10.) Oil of Oregano and Other Herbs

  7. (continuation of previous comment)

    When cases of harmful infections become more advanced though, the amount of the medicinal substances a person can glean from eating immune strengthening foods will often not be adaquate to counter the disease. Then, specialized large amount concentrations of these substances, called “nutritional vitamin & herbal supplements,” are needed. When infection cases become extremely advanced and severe, then even strong nutritional supplements will probably not be enough and “regular” antibiotic medications will be needed; those are cases where antibiotics ARE appropriate.