Rutgers study finds antibiotic overuse is caused by misconceptions, financial incentives

The global overuse of antibiotics occurs due to the misconception that they are effective in treating a wide variety of conditions and because many physicians prescribe them upon request, according to a recent Rutgers study.

Approximately 30 percent of antibiotics prescribed in the U.S. are unnecessary, creating 47 million excess prescriptions per year, according to a 2016 study by the Centers for Disease Control and Prevention. 

“We have overestimated the benefit and underestimated the cost, and that’s why there’s so much overuse,” said Martin Blaser, lead author of the Rutgers study and director of the Center for Advanced Biotechnology and Medicine. “If somebody is severely ill, they need an antibiotic. But if they’re only mildly ill, in most cases, they don’t.”

The researchers reviewed more than 200 studies of human antibiotic use, focusing on the reasons behind antibiotic overuse, according to the study. They found that a wide array of misconceptions had been adopted worldwide, based on a number of surveys, including on which common health conditions antibiotics can cure and which germs antibiotics are effective against.

For instance, 57 percent of Europeans said in a national survey they were unaware that antibiotics did not kill viruses, according to the study. In another survey, most Australian parents said they believe antibiotics are necessary for children’s common respiratory infections, including 92 percent of respondents for middle ear infections, 70 percent for sore throat and 55 percent for coughs.

Many people adopt the attitude that antibiotics may not help with a certain condition but will not hurt, when in fact overconsumption can detrimentally affect one’s health in the long run, Blaser said.

“There’s more and more evidence that people who’ve taken antibiotics recently are more likely to develop diabetes, they’re more likely to develop kidney stones, they’re more likely to have certain infections,” he said.

Blaser said antibiotics are especially dangerous for young children because they disrupt the formation of the microbiome, a community of germs within the human body that supports metabolism, immunity and cognition, which children are still developing. Antibiotic use in children is associated with an increased risk of allergic, metabolic and cognitive disorders, according to the study.

Many medical practitioners prescribe antibiotics to fulfill patients’ expectations and avoid losing patients, according to the study.

“Somebody could go to the local pharmacy, and the pharmacist, in general, is happy to sell them an antibiotic,” Blaser said. “That’s how the pharmacist makes their living. So every time an antibiotic is used, money changes hands, and the money in some ways corrupts the system.”

In China, for instance, the widespread use of antibiotics occurs due to the financial incentives physicians are faced with when prescribing antibiotics, according to the study. Such financial motives may combine with lax enforcement of laws and government corruption to facilitate overdistribution of antibiotics to patients.

Solutions to slow down the distribution of antibiotics include improving doctor-to-patient communication on the risks of antibiotics, placing more restrictions on the sale of antibiotics and promoting the use of alternative treatments, according to the study.

“We have to educate people that antibiotics have cost,” Blaser said. “It’s not just benefit. This is the economic model.”