Prescription for nothing? 7 in 10 doctors give patients unnecessary antibiotics for asymptomatic infections

BALTIMORE — Antibiotics can be dangerous to the gut and increase the risk of creating antibiotic-resistant bacterial strains. Despite the danger to “good” bacteria in the body, a new study finds about 70 percent of primary care physicians still believe in prescribing antibiotics for asymptomatic infections.

Since the early 2000s, the attitude towards antibiotics has shifted. Multiple medical organizations advise against prescribing antibiotics for people who test positive for a urinary tract infection (UTI) but show no symptoms such as burning or frequent urination. Medical guidance states antibiotics are not useful for asymptomatic infections and could cause more harm than good.

These side-effects include diarrhea, vomiting, rashes, and yeast infections. In rare cases, antibiotic-resistant strains such as C. difficile have an opportunity to expand in the colon and may cause death. Other cases involve bacterial infections that are deadly or hard to treat.

“Our study suggests that primary care clinicians do not follow widely accepted recommendations against prescribing antibiotics for asymptomatic bacteriuria,” says Jonathan Baghdadi, MD, PhD, Assistant Professor of Epidemiology & Public Health at the University of Maryland School of Medicine and lead author of the study, in a university release. “Some primary care clinicians may be unaware of these recommendations, but a culture of inappropriate prescribing is also likely a contributing factor.”

Certain doctors are more likely to give out prescriptions

The study looked at the survey answers of 551 primary care doctors from Texas, the Mid-Atlantic, and the Pacific Northwest. The survey presented doctors with a scenario where a patient came in for a bacterial infection but presented no UTI symptoms. They then had to provide their best approach for treatment.

Results show 71 percent of the doctors would give the hypothetical patient antibiotics — even if the treatment went against recommended medical guidelines. The researchers also found that family medicine doctors were more likely to overprescribe antibiotics than doctors in other specialties. Additionally, doctors in residency training or who lived in the Pacific Northwest were less likely to give antibiotics for asymptomatic infections.

“We found other factors also played a role in prescribing like whether a physician had a stronger preference in favor of over-treating a condition and fear of missing a diagnosis; that person was more likely to favor prescribing antibiotics compared to a physician who felt more comfortable with uncertainty in practicing medicine,” explains study leader Daniel Morgan, MD, MS, a professor of Epidemiology & Public Health at University of Maryland School of Medicine.

The study authors suggest changing educational standards for specialties that would more likely overprescribe antibiotics and reshaping the idea that antibiotics are “potentially harmful” than “unnecessary.”

The study is published in JAMA Network Open.

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About the Author

Jocelyn Solis-Moreira

Jocelyn is a New York-based science journalist whose work has appeared in Discover Magazine, Health, and Live Science, among other publications. She holds a Master’s of Science in Psychology with a concentration in behavioral neuroscience and a Bachelor’s of Science in integrative neuroscience from Binghamton University. Jocelyn has reported on several medical and science topics ranging from coronavirus news to the latest findings in women’s health.

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