Study turns the heat on doctors for prescribing wrong medicine

Patients have often been accused of abusing antibiotic drugs and contributing to high resistance levels. But now a new study has turned the heat on doctors accusing them of prescribing antibiotics to manage the wrong ailments.

Researchers who conducted the study say doctors and pharmacists, who are expected to know better, are mismanaging patients by prescribing antibiotics for viral diseases. In many cases, such prescriptions are given without proof that such patients really need the antibiotics, they say.

Antibiotics are known not to manage viral diseases; hence when given, patients may take a long duration to heal.

Antibiotic patients

“In fact, antibiotics may have led to harm in some cases. For example, a significant number of antibiotic patients developed Clostridium difficult diarrhea, a condition linked with antibiotic use,” say Kevin Shiley et al in their study, The Use of Antimicrobial Agents after the Diagnosis of Viral Respiratory Tract Infections in Hospitalized Adults: Antibiotics or Anxiolytics?

Other negative outcomes for the patient were long stay in hospital, huge medical bills, and sometimes increased mortality compared to the group that was not on antibiotics, adds the researchers.

Findings of this two-year long study that involved tracking patients at two Pennsylvania hospitals in the United States will be published in this month’s issue of Infection Control and Hospital Epidemiology journal.

Local doctors admit that the findings are reflective of what is happening in Kenya. While a section of them argue that they prescribe antibiotics because many of their patients are unable to afford tests to help tell if an infection is caused by a virus or bacteria; others think this practice is wrong as it may lead to misuse of the drugs and negative outcomes to the patient.

“I bet that over 90 per cent of the time, antibiotics will be used when they are not supposed to be used to manage the condition the person is suffering from,” says Dr Jeremiah Chakaya, a chest specialist at the Kenya Medical Research Institute (Kemri).

“The truth is, when I have a sore throat and cold, the drugs I rush for are antibiotics. But surprisingly, they seem to work,” says Peter Njeru, a resident of Greenfields estate.

In most of the cases, the infection Njeru suffers from is of viral nature, but since the practice is to use antibiotics, he goes for the drugs whenever he is sick. Studies have shown that immune response helps to resolve viral infections like cold within one week, and not antibiotics.

Pharmaceutical players have been accused of failing to inform the consumers like Njeru about the ineffectiveness of the drugs when used to treat viral infections such as colds. Instead they have kept quiet as they make handsome profits.

The publication of the study comes at time when several studies show abuse of antibiotics in the country to have reached epidemic levels. High resistance to these drugs is now forcing individuals and government to dig deeper into their pockets to buy expensive antibiotics that can manage the resistant strains.

“With an increase in self-medication, the use of antibiotics to manage respiratory tract infections of viral nature is likely to be higher,” says Prof Surendra Patel, a specialist in infectious diseases and a lecturer at the University of Nairobi.

In their study, Kevin Shiley et al found that majority of the patients hospitalised with respiratory tract infections caused by viruses were wrongly treated with antibiotics, usually used in managing bacterial infections.

Of the 196 patients who were diagnosed with viral infections, 125 remained on antibiotics after their diagnoses. Although the researchers said it was permissible to put the patients on antibiotics if an abnormal chest x-ray suggests a concurrent bacterial infection, only 37 per cent of the patients had abnormal chest x-rays.

“These data demonstrate at least one area where antibiotics are commonly used in hospitalised patients without clear reason,” say study authors Kevin Shiley, Ebbing Lautenbach and Ingi Lee, from the University of Pennsylvania School Of Medicine, who are quoted in the recent publication of Health and Medicine.

“Even when you feel better after taking antibiotics, they might not have played a role in the improvement of your condition. We advice patients to give time to ailments like cold to resolve within at least one week.

AWC Features