Health care experts around the world have repeatedly warned about the overuse and misuse of antibiotics, particularly with children. But the problem isn't only with kids ... medical doctors are continuing to over-prescribe the drugs for adult patients as well, often when they aren't needed.

Increasingly concerned about the health threats from excessive antibiotic use, the Centers for Disease Control (CDC) convened a panel of national health experts to develop best treatment guidelines for adults with colds and acute upper respiratory infections.

The guidelines, "Principles for Appropriate Antibiotic Use," were released in the Annals of Internal Medicine and target the overuse or misuse of antibiotics.

Typically, the best treatment for otherwise healthy adults with acute bronchitis, colds and most types of sore throats is to simply help alleviate symptoms, according to the new principles.

The panel -- made up of physicians from specialties in internal medicine, family medicine, emergency medicine and infectious disease -- said that, all too often, antibiotics are prescribed for adults with upper respiratory infections caused by viruses, which do not respond to antibiotics meant to treat bacterial infections.

Research indicates that 75% of antibiotics prescribed in outpatient settings are for respiratory infections. Each year in the United States, an estimated 50 million antibiotic prescriptions are for illnesses such as colds or flu for which antibiotics offer no benefit.

The majority of antibiotics prescribed for adults in outpatient settings for acute respiratory infections such as sinusitis, pharyngitis, bronchitis and the common cold, offer little or no benefit to the patient.

In addition, treating viral acute respiratory infections with antibiotics promotes the spread of antibiotic-resistant bacteria.

The American Academy of Family Physicians (AAFP), the American College of Physicians- American Society of Internal Medicines (ACP-ASIM), and the Infectious Disease Society of America (IDSA) contributed to the new guidelines.

To curtail the rise of community-acquired antibiotic resistant infections, the CDC, AAFP, ACP-ASIM, and IDSA collaborated on the principles to provide medical clinicians strategies to encourage antibiotic use for those patients most likely to benefit from them.

"By promoting a better understanding of the appropriate use of antibiotics, we are attempting to change the entire culture around which antibiotics are prescribed," said Health and Human Services Secretary Tommy G. Thompson. "We are working toward a day when a patient or parent sees his or her health care provider and rather than requesting an antibiotic, asks for the best treatment available."

The excessive use of antibiotics among outpatients has contributed to the emergence and spread of antibiotic-resistant bacteria in many communities. Increasing antibiotic resistance among common pathogens is leaving fewer effective drugs available to treat infectious diseases.

When resistance develops in first-line drugs, the remaining alternative drugs may be less effective, more expensive and more difficult to administer. The resistant pathogens are a growing menace to all people, regardless of age, sex, or socioeconomic background.

"When health care providers use these principles they can greatly reduce the health threats caused by excessive antibiotic use," said CDC Director Jeffrey Koplan, M.D.

SOURCES: "Principles for Appropriate Antibiotic Use," Annals of Internal Medicine, March 19, 2001.