Most upper respiratory infections such as colds and ear infections are viral--and they don’t respond to antibiotics. Still, doctors often prescribe antibiotics for such ailments, which is one of the culprits behind the increase in antibiotic-resistant bacteria.
Doctors should continue to err on the side of not prescribing antibiotics for viral infections--even when there’s a rare chance that bacterial complications associated with respiratory infections can occur, according to a study published in the BMJ.
In their study of more than 4 million patients at 610 physician practices in the United Kingdom, researchers found that practices that prescribed fewer antibiotics to treat respiratory tract infections didn’t witness an increased rate of bacterial complications such as meningitis, brain abscess or infections of the mastoid bone behind the ear.
“Our paper should reassure [general practitioners] and patients that rare bacterial complications of respiratory infections are indeed rare,” said Mark Ashworth, M.D, one of the study authors from the King’s College London’s division of health and social care research, in an announcement. “Fortunately, if there are any signs of a complication, the [general practitioner] can quickly step in and offer an appropriate antibiotic.”
There are slightly higher rates of pneumonia and peritonsillar abscess--a complication related to tonsillitis--when doctors limit prescriptions for upper respiratory infections, researchers discovered. In real-world terms, that means that a practice with 7,000 patients that reduces such prescribing behavior by 10 percent could lead to one case of pneumonia each year. Practices of this size may also see an extra case of peritonsillar abscess every ten years, according to the study.
The results of this study represent averages across physician practices, say researchers, who note that they didn’t focus on outcomes for individual patients.