Over 70% of Physicians Still Prescribe Unsafe Antibiotics – Which Can Be Deadly

Prescription Medicine Concept

The overwhelming body of evidence shows that antibiotics are ineffective for asymptomatic people and may cause side effects such as diarrhea, vomiting, rashes, and yeast infections.

According to a survey, more than 70% of doctors said they would administer antibiotics to treat asymptomatic bacteria found in urine tests, disobeying recommended guidelines

A study of primary care doctors found that, on the basis of a single positive urine sample, an estimated 70% of them would still recommend antibiotics to treat asymptomatic infections. According to a study recently published in the journal JAMA Network Open, this is despite long-standing medical standards that advise against this practice. Researchers from the University of Maryland School of Medicine (UMSOM) directed the study.

Medical associations have opposed the regular use of antibiotics for individuals with bacteria found in a urine culture but no signs of a urinary tract infection (UTI), such as burning or frequent urination, since 2005. Overwhelming evidence suggests that the drugs are ineffective for asymptomatic patients and can instead cause side effects such as diarrhea, vomiting, rashes, and yeast infections. In rare instances, antibiotics can even result in death due to an excess of the harmful bacteria C. difficile in the colon. The overuse of these medications has also led to an increase in bacterial infections that are difficult to treat and sometimes fatal due to their resistance to antibiotics.

In the study, 723 primary care professionals from Texas, the Mid-Atlantic, and the Pacific Northwest were questioned about how they would treat a fictitious patient with asymptomatic bacteriuria, which is when bacteria are detected in the urine of a patient who has no signs of a urinary tract infection. They discovered that, despite doing so going against the recommended guidelines, 392 out of the 551 physicians who responded to the study (71%) would choose to treat such a patient with antibiotics.

“Our study suggests that primary care clinicians do not follow widely accepted recommendations against prescribing antibiotics for asymptomatic bacteriuria,” said lead author Jonathan Baghdadi, MD, Ph.D., Assistant Professor of Epidemiology & Public Health at UMSOM. “Some primary care clinicians may be unaware of these recommendations, but a culture of inappropriate prescribing is also likely a contributing factor.”

Compared to other specialties, family medicine doctors were more likely to give unnecessary antibiotic prescriptions. Physicians in residency or living in the Pacific Northwest were less likely to administer antibiotics.

“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,” said study leader Daniel Morgan, MD, MS, Professor of Epidemiology & Public Health at UMSOM.

One strategy to change practice could be an education program targeting physicians who place a high priority on treating just to make sure they do not miss a possible infection, the researchers said in the conclusion section of the article. For example, reframing “unnecessary treatment” with antibiotics as “potentially harmful” treatment with antibiotics could help curb the tendency toward overprescribing.

UMSOM faculty and staff Lisa Pineles, MA, Alison Lydecker, MPH, Larry Magder, Ph.D., and Deborah Stevens, LCSW-C, MPH, were study co-authors. Researchers from the University of Colorado School of Medicine and the Memorial Sloan Kettering Cancer Center also contributed to this study.

The research was funded by the New Innovator Award from the National Institutes of Health and the University of Maryland, Baltimore Institute for Clinical & Translational Research/Clinical and Translational Science Award.

“This is an important finding that points to the importance of continuing medical education to help change lingering attitudes towards antibiotics that are out of date with the current guidelines,” said E. Albert Reece, MD, Ph.D., MBA, Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. “Physicians are taught to first do no harm, and now we know that overtreatment with antibiotics could lead to real harm.”

Reference: “Exploration of Primary Care Clinician Attitudes and Cognitive Characteristics Associated With Prescribing Antibiotics for Asymptomatic Bacteriuria” by Jonathan D. Baghdadi, MD, Ph.D., Deborah Korenstein, MD, Lisa Pineles, MA, Laura D. Scherer, Ph.D., Alison D. Lydecker, MPH, Larry Magder, Ph.D., Deborah N. Stevens, LCSW-C, MPH and Daniel J. Morgan, MD, MS, 27 May 2022, JAMA Network Open.
DOI: 10.1001/jamanetworkopen.2022.14268

6 Comments on "Over 70% of Physicians Still Prescribe Unsafe Antibiotics – Which Can Be Deadly"

  1. Dave Struder | July 21, 2022 at 10:15 am | Reply

    Doofus’

    Cannabinoid science negates pHarma. Eat it killas.. LD50 is o longer mandated , you can’t force this rott on people any more. Knowledge is power bisshes.
    AMA Auschwitz Medical Assassins, how can we HARM you first and make money biopsying you till you croak
    Let them eat cake doc

  2. Physician here. Antibiotics don’t affect viruses at all and ‘germs’ is a colloquial term not a medical term. Overuse of antibiotics is a real danger to us all. And if you think big pharma is out to get us…Dave Struder looking at you…no one is forcing you to accept medical care if you feel it isnt helpful.

  3. My Dr put me on 5 different anti- everything for 2 weeks. Anti parasitic, antimicrobial, antibiotic and antifungal medicine. On top of my supposed paranoid schizophrenic meds lithium and Lexapro. My urine was coke and my stool was blood. My house has had a sewage leak for over a year and my digestive state had been bad but not like this. I figured it was worms, because of the fact that my animals were all getting sick also. My kidneys are and abdominal organs all are painful, I’ve never had covid or the vaccine. She had the Johnson shot and had covid while treating me as her patient. Still covid free.
    My mom had just been diagnosed with a high grade malarian cancer that took over her intestines and in 2 months. Leaving me with no one to run to for answers to the women’s body. Her stomach was so bloated with fluids her intestines burst.

  4. Andrew Johnstone, RPh/MD | July 22, 2022 at 8:20 pm | Reply

    Today’s “widely accepted guidelines” are often tomorrow’s “quaint if not dangerous obsolete practices”, and vice versa. Intelligent physicians INDIVIDUALIZE care based on science and logic, and DON’T just follow ‘consensus’ or ‘protocols’, whether old OR new.

  5. Joshua Jordan | July 23, 2022 at 1:25 am | Reply

    So, to stop Physicians from prescribing medications that are low risk & saves lives, the idea is to reframe these medications so that everyone involved believes the prescribed medication is ~high risk, dangerous, & can sometimes even be fatal.

    That’s quite possibly the absolute worst solution to AB resistance I’ve ever heard. You don’t reframe the empirical facts for a doctor because then they won’t prescribe, & the pt misinformed is less likely to take/finish their prescription, policy makers/hospital administrators become overly restrictive towards these medications, etc. AND for what?! Is reframing or not reframing going to cause more people to die from bacterial infections or have life threatening complications related to bacterial infections. I’d say reframing would do far worse. Maybe it works out in highly controlled research scenarios, but realistically…it would be a catestrophic failure of medicine.

    There are other effective ways to stop AB resistance. One way is through free market competition – if bigPharma were subject to it, solutions would be a dime a dozen. Instead, nobody makes new ABs. Another way, while bigPharma sits idle, is to coordinate & randomly cycle AB coordinated formulations from what’s available by regions every 3—6 months. Don’t let bacteria set the pace of

  6. Many people are “asymptomatic ” with UTIs, aka bacteria in their urine.
    This story is insinuating false information. I’ve seen more patients can sepsis from an untreated UTI than c-dif from being treating.

    Let the doctors o their jobs,, to determine who needs antibiotics, like they are trained for.

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