Smokers often prescribed antibiotics; impact on antibiotic resistance could be dramatic

By Aine Cryts

Clinicians are more likely to prescribe antibiotics to smokers for infections, a troubling trend that contributes to antibiotic resistance, according a recent study published in the Journal of Preventative Medicine.

In a study of 8,307 doctor's office visits that included a diagnosis of an infection, smokers were about 20 percent more likely to be prescribed antibiotics. When researchers focused specifically on respiratory infections, they discovered that smokers were 31 percent more likely to be prescribed antibiotics.

At least two million people become infected with antibiotic-resistant bacteria each year--and, of that number, at least 23,000 people die, according to the Centers for Disease Control and Prevention.

"If smokers are being prescribed antibiotics 20 to 30 percent more than other individuals, if not indicated, it's going to contribute to that antibiotic resistance in society and bacteria are going to become more and more resistant," wrote lead author Michael Steinberg, M.D., chief of the division of general internal medicine at Robert Wood Johnson Medical School at Rutgers University.

This prescribing activity seems to result from an inaccurate perception among physicians that smokers are more susceptible to infection than non-smokers, Steinberg told Reuters Health.

Patient demand, physician uncertainty of diagnosis and time pressure all contribute to this trend. It helps to acknowledge to patients that they've received antibiotics in the past, but there's been a shift in best practice, recommends Molly Cooke, M.D., past president of the American College of Physicians and professor of medicine at the University of California-San Francisco.

Treating patients with a bacterial illness, such as an ear or sinus infection, can present a challenge if they expect to receive an antibiotic. Make sure to follow-up with these patients to ensure their condition doesn't get worse and require additional treatment, advises Wanda Filer, M.D., president of the American Academy of Family Physicians.

To learn more:
- read the study abstract
- check out the Reuters Health article