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Antibiotics Do Nothing for Most Sore Throats

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WebMD Health News

Sept. 12, 2001 -- Lots of people seek out a doctor to cure a sore throat, but a new study shows that antibiotics are almost always a waste of time -- and often, may do more harm than good.

"Antibiotics can only help patients if they have strep throat, which is caused by bacteria," says Jeffrey A. Linder, MD. "If you have that particular kind of sore throat, taking penicillin can reduce your symptoms by about a day and limit associated problems such as ear infections and sinusitis." Linder is a research and clinical fellow in the general medicine division of Massachusetts General Hospital in Boston.

However, viruses cause most sore throats, so antibiotics do no good at all. "For most sore throats, all we can do is treat the symptoms with over-the-counter medications such as lozenges, sprays, ibuprofen, and Tylenol, Linder says.

Linder is the lead author of a study on sore throat treatment published in the Sept. 12 issue of the Journal of the American Medical Association. In this study, researchers found that only about one in 10 adults who visited their doctor for help with a sore throat actually had strep throat and could benefit from antibiotics. But a whopping 73% still got these drugs.

"This is not a big surprise," says Randolph Regal, PharmD. "Previous studies have shown when antibiotics are prescribed for upper-respiratory infections, about half the time, they're totally inappropriate." Regal is a clinical professor of internal medicine/infectious disease at the University of Michigan College of Pharmacy and University Hospital, in Ann Arbor.

Experts recommend that penicillin be given if you have strep throat or erythromycin if you are allergic to penicillin. However, the researchers found that among people who took antibiotics, nearly seven in 10 of were given inappropriate antibiotics that wipe out many types of bacteria and are much more expensive.

R. Patrick McManus Jr., MD, tells WebMD that although penicillin has been around for many years, it is still very effective in fighting strep throat. "Ideally, you want to use a drug that kills the bacteria causing the problem, and nothing else." Getting rid of other types of bacteria makes antibiotics less useful for you down the road and can lead to severe side effects as well, he says.

McManus is clinical assistant professor of Medicine at Jefferson Medical College of Thomas Jefferson University, and he is a primary care physician at Thomas Jefferson University Hospital, both in Philadelphia.

Lindner says there is a lot of confusion among patients, who often believe incorrectly that having a sore throat automatically means treatment with antibiotics. But even when antibiotics are appropriate, many people are mistaken in thinking the ones just reaching the market now will always be the most effective drugs to take.

"For some reason [people] have the perception that newer antibiotics must be stronger," Linder says. "Actually the bacteria that causes strep throat is often resistant to newer medicines, whereas penicillin always works."

And when antibiotics are not needed, using them can lead to antibiotic-associated diarrhea, says Regal. Even worse, it increases the chance the bacteria within your body will become resistant to these sophisticated medicines.

"We contain billions of bacteria in our bowels, and with each course of antibiotics, you increase the chance they'll become resistant," Regal says. He adds it is important for people not to encourage their doctor to give them an antibiotic, since the risk of developing problems from using these drugs inappropriately is often greater than any benefit they might get.

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