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Study Reports Overuse of Antibiotics Within the U.S.

Dana Jerusalmi

Last updated: November 9, 2016 8:37 pm

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Antibiotics are a type of medication that treat infections caused by bacteria, fungi and specific parasites. Very often antibiotics are prescribed to “treat” illnesses for which they have no benefit, such as those caused by viruses. A recent article published in the Journal of the American Medical Association (JAMA) found that almost a third of antibiotic prescriptions given on an outpatient basis, tens of millions a year, were inappropriate. 1

Certain antibiotics, such as fluoroquinolones, carry severe side effects. Due to these side effects, they can be especially harmful to take when unwarranted. 2

FDA Warns Against Overusing Antibiotics

In a statement issued May 2016, the U.S. Food and Drug Administration (FDA) advised that fluoroquinolones should only be prescribed when no other treatment options exist for patients with acute bronchitis, sinusitis and uncomplicated urinary tract infections. This safety communication was issued in response to an FDA safety review that revealed, “that fluoroquinolones when used systemically… are associated with disabling and potentially permanent serious side effects that can occur together.” 3

Some fluoroquinolone antibiotics include:

  • Ciprofloxacin (Cipro, Cipro XR, and Proquin XR)
  • Gemifloxacin (Factive)
  • Levofloxacin (Levaquin)
  • Moxifloxacin (Avelox)
  • Norfloxacin (Noroxin)
  • Ofloxacin (Floxin)

Dangers of Prescribing Antibiotics That Are Unnecessary

Most unnecessary antibiotic prescriptions are written for viral conditions that do not respond to antibiotics, including the common cold, influenza, bronchitis and the majority of sore throats. 4

Not only do antibiotics not clear viral infections, their unnecessary use may cause painful or uncomfortable side effects that are suffered needlessly. 5 Overusing antibiotics may also promote antibiotic resistance, which occurs when antibiotics can no longer control or stop the spread of bacterial growth because bacteria have evolved to develop immunity to antibacterial medications. 6

The Centers for Disease Control and Prevention (CDC) has indicated that in the U.S. every year, “at least 2 million people acquire serious infections with bacteria that are resistant to one or more of the antibiotics designed to treat those infections.” These antibiotic-resistant infections cause over 23,000 deaths every year in the U.S. 7

Side effects of antibiotics can affect a patient’s:

  • Tendons
  • Muscles
  • Joints
  • Nerves
  • Central Nervous System 8

Increased Risk of Aortic Aneurysms and Aortic Dissection

Overusing antibiotics can cause patients to suffer from unnecessary, harmful side effects. Fluoroquinolones are amongst the most commonly prescribed antibiotics and are often used to treat urinary tract, skin and respiratory infections. 9

In a recent 2015 study, use of fluoroquinolones was found to almost triple the risk of aortic aneurysms. 10

Aortic aneurysms are a bulge in the wall of the aorta, the main artery that transports oxygen-rich blood from the heart to the rest of the body. Aneurysms can burst, among other complications, leading to significant internal bleeding, which can be fatal. 11

Another 2015 study found increased risk of aortic dissection when taking fluoroquinolone antibiotics. The study found use of fluoroquinolones corresponded with a significant, more than doubling of the rate of aortic aneurysm or dissection. 12

In an aortic dissection, the interior layer of the aorta tears and the layers of the vessel separate as blood slips through the torn layer. Aortic dissection can be fatal. 13

Read more about the possible side effects of taking fluoroquinolone antibiotics.

Overuse of Antibiotics: How Common Is It?

A recent article published in JAMA looked at data from outpatient visits across the U.S. from 2010-2011. It found that almost 13 percent of visits examined resulted in an antibiotic prescription. The authors found that around 50 percent of antibiotics that were prescribed for acute respiratory conditions may have been unwarranted. Additionally, approximately 30 percent of all oral antibiotic prescriptions examined may have been unnecessary. 14

Overall, the Centers for Disease and Prevention (CDC) estimates that at least 2 million people a year in the US are infected with antibiotic-resistant bacteria, and at least 23,000 die from these infections. Overuse of antibiotics, particularly in hospitals, can actually cause a serious infection called C. difficile, which infects 250,000 people a year, killing an estimated 14,000.

Yet, the CDC finds, a third of antibiotics prescribed in hospitals may be unnecessary or prescribed for too long. Overall, the agency estimates, about half of all antibiotics prescribed are unnecessary. In addition, antibiotics can wipe out “good” bacteria and yeast in your gut, leading to other infections such as urinary tract or vaginal infections. Studies suggest this may also contribute to obesity, asthma, allergies, and autoimmune diseases, among other medical conditions. 15

Preventing Antibiotic Overuse

You can do your part to reduce antibiotic overuse and antibiotic-resistant bacteria:

  • Don’t pressure your doctor to prescribe an antibiotic unless you have a bacterial infection. Signs of such infections include fever, being sick for a week or more, greenish or yellowish mucous from your lungs or nose, and white spots on a sore throat.
  • Take antibiotics only if your doctor prescribes them; don’t take someone else’s prescription or use leftover antibiotics. Antibiotics are designed to work against particular bacteria, so one prescribed for someone else probably won’t be effective against the type causing your illness.
  • Take antibiotics as directed. Even if you feel better after a couple of days, you need to finish the entire prescription. If your doctor stops the antibiotic to start you on a different one, throw out the unused portion.
  • Let your doctor know about any side effects, including nausea, diarrhea, or allergic reactions. Watch out for severe diarrhea, even months after taking the antibiotic, which could be a sign of C. difficile.
  • Ask your doctor about any special instructions for the antibiotic. For instance, some make you extremely sensitive to sunlight; others can make oral contraceptives less effective; some require that you avoid alcohol or take the drug with food.
  • Ask your doctor about taking a probiotic along with or just after taking the antibiotic to protect and replenish the “good” bacteria in your gut.
  • Choose antibiotic-free meat and poultry. The use of antibiotics in animals also contributes to antibiotic resistance and the destruction of “good” bacteria.
  1. http://jama.jamanetwork.com/article.aspx?articleid=2518263; http://familydoctor.org/familydoctor/en/drugs-procedures-devices/prescription-medicines/antibiotics-when-they-can-and-cant-help.printerview.all.html 

  2. http://www.fda.gov/Drugs/DrugSafety/ucm500143.htm 

  3. http://jama.jamanetwork.com/article.aspx?articleid=2518263;  https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/1-in-3-antibiotics-prescribed-in-u-s-are-unnecessary-major-study-finds/ 

  4. http://www.cdc.gov/features/getsmart/ 

  5. http://www.emedicinehealth.com/antibiotics/page4_em.htm; http://www.fda.gov/Drugs/DrugSafety/ucm500143.htm 

  6. http://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf 

  7. http://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf 

  8. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm500665.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery 

  9. http://bmjopen.bmj.com/content/5/11/e010077.full.pdf+htmlhttp://livertox.nih.gov/Fluoroquinolones.htm 

  10. http://bmjopen.bmj.com/content/5/11/e010077.full.pdf+html  

  11. http://www.webmd.com/heart-disease/tc/aortic-aneurysm-overview  

  12. http://archinte.jamanetwork.com/article.aspx?articleid=2451282 

  13. http://www.mayoclinic.org/diseases-conditions/aortic-dissection/basics/definition/con-20032930 

  14. http://jama.jamanetwork.com/article.aspx?articleid=2518263 

  15. Blaser M. Antibiotic overuse: Stop the killing of beneficial bacteria. Nature. 2011; 476:393–394