Antibiotic Overuse: Clinicians Are the Solution
Authors: Barbara E. Jones, Matthew H. Samore
Journal: Annals of Internal Medicine (2017)

Editorials6 June 2017Antibiotic Overuse: Clinicians Are the SolutionBarbara E. Jones, MD, MSc and Matthew H. Samore, MDBarbara E. Jones, MD, MScFrom Salt Lake City VA Health System and University of Utah, Salt Lake City, Utah.Search for more papers by this author and Matthew H. Samore, MDFrom Salt Lake City VA Health System and University of Utah, Salt Lake City, Utah.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-1061 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Appeals to use antibiotics wisely are as old as penicillin itself. The potential for antibiotic abuse was recognized even during the early era of the “wonder drugs” (1). A 1956 U.K. study of patients with “acute chest infections” found that 82% received antibiotics (2), and in 1962, an expert panel concluded that there was no evidence that antibiotics were beneficial for colds or other upper respiratory viral infections (3).Now, more than 5 decades later, an unacceptably high proportion of patients with viral respiratory infections still receive antibiotics. In their article, Silverman and colleagues (4) report that among a low-risk ...References1. Long PH. The use and abuse of chemotherapeutic and antibiotic agents. N Engl J Med. 1947;237:837-9. [PMID: 20271311] doi:10.1056/NEJM194712042372302 CrossrefMedlineGoogle Scholar2. Acute chest infection in general practice; a group investigation by 55 general practitioners, organized by the Research Committee of Council of the College of General Practitioners. Br Med J. 1956;1:1516-20. [PMID: 13316199] MedlineGoogle Scholar3. Langer E. Antibiotics: experts question value in treating colds; FDA issues ban on use in compounds. Science. 1963;141:791. [PMID: 17747543] CrossrefMedlineGoogle Scholar4. Silverman M, Povitz M, Sontrop JM, Li L, Richard L, Cejic S, et al. Antibiotic prescribing for nonbacterial acute upper respiratory infections in elderly persons. Ann Intern Med. 2017;166:765-74. doi:10.7326/M16-1131 LinkGoogle Scholar5. Bredemeyer M. ACP/CDC provide guidelines on the use of antibiotics for acute respiratory tract infection. Am Fam Physician. 2016;94:1016. [PMID: 28075087] MedlineGoogle Scholar6. The tragedy of the commons. Science. 1968;162:1243-8. [PMID: 17756331] CrossrefMedlineGoogle Scholar7. Podolsky SH, Bud R, Gradmann C, Hobaek B, Kirchhelle C, Mitvedt T, et al. history teaches us that confronting antibiotic resistance requires stronger global collective action. J Law Med Ethics. 2015;43 Suppl 3:27-32. [PMID: 26243240] doi:10.1111/jlme.12271 CrossrefMedlineGoogle Scholar8. Blaser MJ, Falkow S. What are the consequences of the disappearing human microbiota? Nat Rev Microbiol. 2009;7:887-94. [PMID: 19898491] doi:10.1038/nrmicro2245 CrossrefMedlineGoogle Scholar9. Jones BE, Sauer B, Jones MM, Campo J, Damal K, He T, et al. variation in outpatient antibiotic prescribing for acute respiratory infections in the veteran population: a cross-sectional study. Ann Intern Med. 2015;163:73-80. [PMID: 26192562]. doi:10.7326/M14-1933 LinkGoogle Scholar10. Lewis VA, Fisher ES. Social networks in health care: so much to learn [Editorial]. JAMA. 2012;308:294-6. [PMID: 22797649] doi:10.1001/jama.2012.7476 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Salt Lake City VA Health System and University of Utah, Salt Lake City, Utah.Grant Support: Dr. Jones is supported in part by CDA Award 15-061 from the U.S. Department of Veterans Affairs Health Services Research and Development. Dr. Samore is supported by Center of Innovation grant 150HX001240 from the U.S. Department of Veterans Affairs Health Services Research and Development. Their work is also supported by funds from the Centers for Disease Control and Prevention (14FED1412883 and 200-2011-42039/0009).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-1061.Corresponding Author: Barbara E. Jones, MD, MSc, Salt Lake City VA Health System, 633 8th Avenue, Salt Lake City, UT 84103; e-mail, barbara.[email protected]utah.edu.Current Author Addresses: Drs. Jones and Samore: Salt Lake City VA Health System, 633 8th Avenue, Salt Lake City, UT 84103.This article was published at Annals.org on 9 May 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAntibiotic Prescribing for Nonbacterial Acute Upper Respiratory Infections in Elderly Persons Michael Silverman , Marcus Povitz , Jessica M. 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