DETROIT -- A study reported this week in the Journal of the American Academy of Pediatrics shows a dramatic drop in the number of antibiotics prescribed to American children in recent years. This reversal of a 20-year rise in antibiotic prescriptions is good news for organizations like Blue Cross Blue Shield of Michigan and its HMO affiliate, Blue Care Network, which have worked with a coalition of hospitals, physicians, public health agencies and others to encourage careful antibiotic use.
The company's research shows that Michigan is following the national trend. The Michigan Blues reported a 16 percent reduction in prescribing of antibiotics among its more than four million health plan members in 2002, compared to 1998.
Unnecessary prescribing poses a public health risk as bacteria develop resistance to antibiotics. For instance, in one out of every eight Michigan cases of pneumonia, otitis media or meningitis caused by streptococcus pneumoniae, penicillin is now ineffective for treatment. Data also shows that up to 40 percent of antibiotics prescribed in doctors' offices were prescribed for viral infections for which antibiotics are ineffective.
Since 1998, the Blues have measured the appropriate use of antibiotics. The overall rate of antibiotic use for Blues members under age 65 with acute upper respiratory infections, which are usually viral in nature and do not require antibiotics, was 51 percent during the 2002 data year. Back in 1998, it was 61 percent. This represents a 16 percent decrease in just four years.
Through its involvement in the Michigan Antibiotic Resistance Reduction (MARR) Coalition, a non-profit coalition dedicated to promoting the responsible use of antibiotics, the Michigan Blues have worked to raise awareness that antibiotics are appropriate to treat bacterial infections but are not effective for viral infections. The best medicine for many viral illnesses remains bed rest, liquids, and over-the-counter remedies for symptomatic relief.
"This downward shift is good news but there still is work to be done to further reduce the unnecessary use of antibiotics," says David Share, MD, clinical director for the Blues' Center for Health Care Quality and Evaluative Studies.
Share said the Blues' study indicates children tended to receive antibiotics at a lower rate than adults, who represent the largest segment of cases in the study. The most significant decline was seen for upper respiratory infections, which was down by 27 percent. This was followed by the common cold, representing 22 percent and in the smallest decrease, acute bronchitis at just five percent.
"We clearly still have much work to do with respect to informing the public and clinicians that acute bronchitis can be treated without using antibiotics," said Share.
Source: Blue Cross Blue Shield of Michigan