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Overprescribed Antibiotics for Colds Causes Patient Harm

Researchers identify hundreds of thousands of cases of resulting diarrhea, candidiasis, and Clostridium difficile infections needing medical attention

By Lori Solomon HealthDay Reporter

THURSDAY, April 27, 2023 (HealthDay News) — Overprescribing of antibiotics for acute upper respiratory infections (aURIs) causes significant patient harm, according to a study published in the April issue of the Journal of Internal Medicine.

Harris Carmichael, M.D., from the Stanford University School of Medicine in California, and colleagues analyzed data from 51 million patient encounters to determine the odds of clinically detectable adverse events following antibiotic use compared with events among unexposed individuals with aURIs.

The researchers found that 62.4 percent of the population received antibiotics in an aURI encounter. In the antibiotic-exposed group, observed adverse events included 54,279 for diarrhea and 46,936 for candidiasis (adjusted odds ratios [aORs], 1.24 and 1.61, respectively; number needed to harm: 3,126 and 1,975, respectively). For Clostridium difficile infection (CDI), the exposed group had 30,133 observed events (aORs of isolated CDI and combined adverse events were 1.07 and 1.30, respectively; number needed to harm: 17,695 and 1,150, respectively). Adverse events were more common among females. Following a URI, antibiotics resulted in 5.7 additional cases of CDI per 100,000 outpatient prescriptions.

“These findings underscore that inappropriately giving patients antibiotics is causing real and widespread harm,” Carmichael said in a statement. “Having these kinds of side effects for one in a few hundred, or even a thousand, patients may not seem like a lot, but when you look at this problem on a population health level, we’re talking about hundreds of thousands of adverse events severe enough that these patients needed additional care from a doctor.”

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