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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  1. The over prescribing of antibiotics is why so many kids today have such severe food allergies. Antibiotics kill everything good and bad bacteria, mothers pass their gut bacteria(or lack thereof) onto their children. GPs should be held liable.

  2. If a patient comes in with a problem, it’s because there is a problem. People don’t just go to doctors for fun. If a doctor refuses to address your problem, you need to look for a new doctor. If they say it’s not bacterial fine, as long as they present a treatment plan and followup seeking a resolution of said problem.

    However if they do nothing, it’s needless suffering. Doctors usually miss a proper diagnosis. I’ve unfortunately struggled with health issues and most of the time there are just no actual answers or serious attempts at treatment. If an antibiotic will cure issues at least prescribe it and see.

    Again, nobody goes to a doctor if they don’t have some sort of health issue. It can’t just be nothing. In most cases it’s probably either bacterial or cancer. If you’re not going to prescribe the antibiotics then you better start getting the cancer scans.

    1. “If a patient comes in with a problem, it’s because there is a problem. People don’t just go to doctors for fun.”

      Paramedic here, 100% not true.

      “ In most cases it’s probably either bacterial or cancer.”

      You have to be trolling. This is the most ridiculous thing I’ve heard in a LONG time.

      1. OK, Mr. or Ms. paramedic, why is this not true? Explain yourself unless you are a bot or a paid shill!

  3. This is a huge problem. Patients request antibiotics routinely. If the doctor declines to prescribe them, the patient will shop around until they get them. Patients enjoy being prescribed antibiotics. Doctors acquiesce.

  4. So how is it that a patient would come in for a “bacterial infection” but have no symptoms? As a physician, this study sounds pretty suspect.

  5. My dentist prescribed an antibiotic as a preventive measure after prepping for a tooth implant two years ago. As a result, I developed a chronic UTI for which my GP prescribed several rounds of different antibiotics because they weren’t working. I finally did my own research and have been treating it naturally with probiotics, prebiotics and vitamins. I’m doing much better but my gut biome is still out of whack. I don’t want to ever take another antibiotic as long as I live.

  6. One of many reasons I don’t trust doctors or the medical field as a whole. I’ll take my chances like everyone in human history.

  7. If they don’t meet their prescription goals, how can they expect to score those free vacation trips?

  8. I came down with a terrible c-diff infection a few years ago, after being prescribed antibiotics for a cut that required stitches. I’m in my 50’s and have been prescribed antibiotics since childhood for various illnesses, most of them minor. I’ve suffered from IBS for years. I feel that overuse of antibiotics has definitely affected my gut health in a negative way, and contributed to my having IBS. After the c-diff was successfully treated I began taking probiotics every day and they have made a big difference. I now refuse antibiotics for any minor illness, or if I absolutely have to take them I will make sure I double up on the probiotics during the course of the antibiotics.

  9. the title of this article, should have read:
    “Prescription for PROFIT! 7 in 10 doctors give patients unnecessary antibiotics for asymptomatic infections”

  10. Stop pretending it’s a “prescriber” issue and admit it’s a “patient demand” issue.
    Patients insist on treatment, and have all sorts of weapons for retribution on a physician who doesn’t agree to their demands.
    The “woke” society has insisted on catering to patients, so here is the result!

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