Debate Over Antibiotic Use In The 'Cold' Season
October 19th 2007
Antibiotics must be used with care, top doctors recommend today. Despite guidelines advising against the routine use of antibiotics for colds, sore throats and ear infections, they are still commonly prescribed in an effort to avoid complications.
But this use is not justified, say Dr Andrew Hayward of University College London, UK, and his colleagues, reporting in the British Medical Journal on-line.
"There seems to be a substantial gap between evidence based guidance and GPs’ prescribing behaviour," they write.
The authors analysed 3.36m cases of cold seen by GPs, and found that "serious complications were rare", but "the risk of pneumonia after chest infection was high, particularly in elderly people". This risk was "substantially reduced by antibiotic use", they add.
In an editorial, researchers at the University of Antwerp, Belgium say the risk of serious complications must be balanced against causing antibiotic resistance by treating infections unnecessarily.
They agree that most infections can be managed by "watchful waiting", and hope that the European Centre for Disease Prevention and Control’s 2008 European antibiotic resistance day "might act as a catalyst for further reductions in antibiotic prescribing".
Also in the journal, experts from the Institute of Child Health, London, UK state that antibiotic-triggered hearing loss could be avoided through genetic screening.
They explain that a group of antibiotics called aminoglycosides carry a well-known risk of damage to the ear in people with a genetic predisposition called m.1555A>G.
They call for the true UK prevalence of this mutation to be discovered so the cost-effectiveness of universal screening can be calculated.
Petersen, I. et al. Protective effect of antibiotics against serious complications of common respiratory tract infections, assessed using the UK General Practice Research Database. British Medical Journal, published online October 19, 2007.
Coenen, S. and Goossens, H. Editorial: Antibiotics for respiratory tract infections in primary care. British Medical Journal, published online October 19, 2007.
Bitner-Glindzicz, M. and Rahman, S. Ototoxicity caused by aminoglycosides. British Medical Journal, Vol. 335, October 20, 2007, pp. 786-87.
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