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Antibiotic Policy
Many preconceptions exist among parents and students regarding the appropriate use of antibiotics.
It has long been recognized that antibiotics are overused in this country. The Center for Disease Control estimates that half of all out-patient antibiotic prescriptions are unnecessary. This overuse of antibiotics has lead to excessive medical costs, unwanted side effects and increasing antibiotic resistance among common bacteria.
The area most responsible for this overuse is in the treatment of respiratory infections such as upper respiratory infections ( the common cold), sore throats & tonsillitis (only Group A Beta Hemolytic strep throat & gonorrhea[a sexually transmitted disease] require antibiotics) and bronchitis (which is viral & unresponsive to antibiotics).
Respiratory infections that do require an antibiotic include:
- 1) Pneumonia, which usually requires a chest x-ray for a diagnosis to be made with certainty.
2) Strep Throat; a sore throat due to Group A Beta Hemolytic streptococcus. This infection requires antibiotics to prevent the (albeit rare) complication of Rheumatic Fever. Even without antibiotics, Strep Throat resolves on it's own within 4-5 days in most cases. Antibiotics will shorten the course of the illness only by about 12-24 hours.
3) Bronchitis in a patient with severe chronic lung disease (often due to a long history of smoking). In this situation the bronchitis may have a bacterial component, as opposed to the case in patients without underlying lung disease, who are often infected with viruses for which antibiotics are not effective.
4) True Bacterial Sinusitis; It is often difficult to make a clear diagnosis of bacterial sinusitis since the symptoms are nearly identical to the common cold (URI). The most useful distinguishing feature is the duration of symptoms. Since viral colds resolve within 10-14 days (and improve within 7-10) ,any "cold" lasting more than 10-14 days may be complicated by a secondary bacterial infection leading to a bacterial sinusitis. In this case antibiotics may be beneficial (though at least 40-50% of bacterial sinusitis cases get better just as quickly without an antibiotic compared to those treated with an antibiotic).
Here at UAlbany we make every effort to practice up to date evidence based medicine which includes a modern cost effective approach to common respiratory infections & appropriate antibiotic use.
For more information on antibiotic use & respiratory infections, view the following patient handout from the American Academy of Family Physicians: Antibiotic Resistance
Peter A. Vellis DO
Medical Director
University Health Center
1400 Washington Ave.
Albany, NY 12222
T: 518-442-5461
F: 518-442-5444
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