Antibiotics are still being overprescribed to children with sore throats, and kids who do need them are often given the wrong ones, a new study shows. It is estimated that at most a third of children who are treated by physicians for sore threat actually have strep throat, with some studies suggesting mat as few as 15% have the bacterial infection. Although many people might refer to any sore throat as “strep throat”, a true strep throat is the one caused by infection from streptococci bacteria. Antibiotics were prescribed to more than half of the children in the new study.

        And roughly one in four prescriptions involved antibiotics other than those recommended, potentially increasing the risk for treatment failure and future drug resistance. The findings are somewhat discouraging in light of aggressive efforts to educate physicians and the public about the dangers of antibiotic overuse. There is a reason for optimism since the total number of antibiotic prescriptions written for children with sore throats fell from 66% in 1995 to 53% in 2003.

        The researchers found that a test that confirms strep throat was given only about half the time seemed to have no impact on whether physicians prescribed antibiotics or not. All kids should be given a strep test before they are treated with antibiotics, they suggest. It doesn’t mean that every child who sees the doctor for a sore throat needs a strep test. If other symptoms indicate a cold or other viral infection no test may be needed.

        Symptoms nor suggestive of strep throat include: Runny nose; Cough; Hoarse voice; Pink eye; Diarrhea; Symptoms, other than sore throat, that suggest strep throat include: High fever; Sudden onset of symptoms; Abdominal pain; Nausea and vomiting; Headache;

        Tender lymph nodes in the neck; the world’s first antibiotic remains the drug of choice for the treatment of children with strep throat. Leading pediatric and infectious groups, recommend penicillin whenever possible. Acceptable alternatives, include other long-relied antibiotics—amoxicillin, erythromycin, and first generation cephalosporin.

        But newer, no recommended antibiotics were prescribed to 27% of the patients who received an antibiotic. Researchers speculate that the physicians and or parents mistakenly believed that newer meant better.

        The irony that the bug that causes strep throat is sometimes resistant to these newer antibiotics, but is never resistant to penicillin. Penicillin is well tolerated, inexpensive, and it has a narrow spectrum of activity, meaning it targets the bug that causes strep throat and little else. The bottom-line is that most kids with sore throats probably shouldn’t be taking antibiotics, and a strep test should always be given before antibiotics were prescribed.

        Doctors need better tools to help them determine which patients will and will not benefit from antibiotics. And they need to make better use of the tools they have, like the strep test, the researchers advised.