In an effort to reduce the growing numbers of drug-resistant
pathogens, the CDC is urging physicians to stop prescribing antibiotics for the common cold and
Dr. Richard Besser, director of antimicrobial resistance for the CDC, told an audience of physicians at the
Royal Society of Medicine antimicrobial resistance conference here that each year US physicians write
$50 million worth of prescriptions that are ineffectual and unnecessary.
"We are facing a crisis because doctors are pressured to prescribe antibiotics for the common cold and
inner ear infection, yet we know that it is not prudent to do so," Dr. Besser said. "We must collectively
inform our patients about the reasons why overprescribing antibiotics will not help patients return to work
sooner, and that in the long run, could make them more susceptible to drug-resistant diseases."
Dr. Besser said that three fourths of all antibiotics prescribed for outpatients in the US are for otitis media,
sinusitis, bronchitis, pharyngitis, or nonspecific upper respiratory tract infection.
The CDC report states that antimicrobials are not indicated for initial treatment of otitis media with
effusion, although treatment may be indicated if effusion persists for 3 months or more. Antimicrobial
prophylaxis should be reserved for control of recurrent acute otitis media, defined as three or more well
documented episodes in 6 months, or four or more episodes in 1 year.
Dr. Besser reviewed research data showing that if unnecessary antibiotic use is curtailed, drug resistance
will diminish. In Japan, for example, 62% of group A streptococcal isolates were resistant to erythromycin
in 1974, when macrolides accounted for 22% of all antibiotic use. By 1988, macrolides accounted for only
8% of antibiotic use, and less than 2% of group A streptococcal isolates were resistant to erythromycin.
Sen. Edward Kennedy, D-Mass., who spoke during the conference, said that he and Senator Bill Frist,
R-Tenn., will introduce legislation to address the "growing problems of antimicrobial resistance and its
threat to public health."
"One of the most urgent priorities to halt the spread of drug-resistant pathogens is to improve the capacity
of state and local public health agencies to monitor and combat infectious disease," Kennedy said. "We
must also educate medical professionals and the public alike to reduce unnecessary prescriptions, and
halt the improper dissemination of antimicrobial drugs."