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Child/Adolescent Health

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Doctors still prescribe antibiotics for over half of children with sore throats

Children's sore throats are usually caused by viruses, which are not treatable with antibiotics, and doctors are prescribing fewer antibiotics for children's sore throats than previously (at 54 percent of visits in 2003 compared to 66 percent in 1995). However, they are still prescribing antibiotics for half of children who have a sore throat, even though only one-third or fewer of these children actually have strep throat caused by group A Beta-hemolytic streptococci (GABHS) bacteria. Doctors also underuse the preliminary testing for strep throat recommended before prescribing antibiotics, according to a study supported by the Agency for Healthcare Research and Quality (HS14563 and HS13908).

Researchers found that physicians prescribed antibiotics in 53 percent of an estimated 7.3 million annual pediatric visits for sore throat. Also, although the antibiotic of choice for strep throat is penicillin (an inexpensive narrow-spectrum antibiotic), physicians prescribed broad-spectrum antibiotics to 27 percent of children who received an antibiotic, and performed a GABHS test in only 51 percent of visits at which an antibiotic was prescribed.

GABHS testing was not associated with a lower antibiotic prescribing rate overall (48 percent tested vs. 51 percent not tested). However, GABHS testing was associated with a 16 percent lower antibiotic prescribing rate for children with diagnosis codes for pharyngitis, tonsillitis, and streptococcal sore throat (57 percent tested vs. 73 percent not tested).

See "Antibiotic treatment of children with sore throat," by Jeffrey A. Linder, M.D., M.P.H., David W. Bates, M.D., M.Sc., Grace M. Lee, M.D., M.P.H., and Jonathan A. Finkelstein, M.D., M.P.H., in the November 9, 2005, Journal of the American Medical Association 294(18), pp. 2315-2322.

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