GW Researcher Finds Medical Care Providers Overprescribe Antibiotics

Despite knowing antibiotics are ineffective against viruses, prescribers often believe they “can’t hurt” a patient with cold or flu symptoms.

June 01, 2018

"Antibiotics can't hurt. They might even make me feel better. Why not take a risk?" You may have had similar thoughts when sick with the flu or common cold. Your doctor may think so, too, according to a new George Washington University study.

David Broniatowski, an assistant professor in the School of Engineering and Applied Science, found that the "Why not take a risk?" mentality is widespread among patients and medical care providers, according to the study released Wednesday. People in both groups often believe that antibiotics "can't hurt" patients with flu or cold symptoms—even though they know antibiotics have side effects.

Antibiotic side effects include vomiting, diarrhea and allergic reaction. Antibiotics are not effective treatment for viruses, but researchers found that providers who know this still believe the antibiotics might help patients feel better.

"When you're feeling sick, you just want to feel better as soon as possible, and the side effects from antibiotics look extremely mild in comparison," Dr. Broniatowski said. "There's always that extremely rare possibility that your disease actually is bacterial."

This "Why not take a risk?" belief might be leading to unnecessary prescribing and to the spread of superbugs, bacteria resistant to antibiotics. Superbugs have caused 23,000 deaths and 2 million illnesses nationwide. According to the Centers for Disease Control and Prevention, the total cost to treat superbugs exceeds $20 billion annually.

"People may be acting strategically—trying to hedge their bets—when they expect or prescribe antibiotics," Dr. Broniatowski said. "Unfortunately, this individually-rational action leads to negative consequences for society."

The research team surveyed 149 clinicians and 225 patients from two large urban academic hospitals, and 519 online nonpatient subjects to determine whether providers share patients' rationales for antibiotic use. The research, "Patients' and Clinicians' Perceptions of Antibiotic Prescribing for Upper Respiratory Infections in the Acute Care Setting," appeared in the journal Medical Decision Making.

The team behind the study included researchers from GW; the Center for Disease Dynamics, Economics & Policy; Johns Hopkins University; University of California, Davis; and Cornell University.

Dr. Broniatowski and his colleagues hope a better understanding of this issue will lead to the development of communication strategies directed to both patients and providers that can be used to reduce inappropriate prescribing, thus alleviating antibiotic resistance.

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