Tony Leys, staff writer | Des Moines Register | September 4, 2003 |
Iowa children are taking more than their share of expensive antibiotics, raising health-care costs and stoking fears of drug-resistant "superbugs," a statewide report said Wednesday.
The report was put together by Wellmark Blue Cross/Blue Shield, Iowa's largest health insurer. It focused on Zithromax, an antibiotic that is heavily marketed as a convenient and effective alternative to older types of antibiotics. Wellmark said 19 percent of its Iowa members used Zithromax or similar brands last year, compared with 14 percent of people nationally.
The drug costs roughly six times as much as older varieties. It is widely advertised to families, with a zebra named Max as its mascot.
"It's a marketer's dream," said Dr. Mary Davis, a Wellmark vice president who worked on the report. Many parents prefer it for ear or throat infections because it usually is taken just once a day for one to five days. The most common older drug, amoxicillin, must be taken two or three times a day for up to two weeks.
The report noted that federal treatment guidelines encourage doctors to hold off on antibiotics or to use the older drugs first for most infections of the ear and throat. That's partly because the older drugs target a narrow range of bacteria. Zithromax attacks many different kinds of germs, raising concerns that its overuse could help create drug-resistant strains.
Zithromax's manufacturer, Pfizer, said its marketing is based on truthful claims about an effective drug. "Our sales force is among the best in the business, and we're proud of the way they present information to doctors," spokesman Daniel Watts said.
The Wellmark report doesn't look at overall use of all types of antibiotics. Other studies have suggested that Iowa doctors and patients were cutting back on misuse of the medicines.
The report said some areas of the state have much higher use than others. Spirit Lake was among the top five areas, with 31 percent of Wellmark customers there receiving prescriptions last year.
Dr. Steven Baskerville, a Spirit Lake physician, said he couldn't account for the numbers. He said he regularly prescribes Zithromax, especially for people who have allergies to other antibiotics.
"It works very, very well," he said.
Baskerville defended the use of the drugs in children with significant ear infections.
"If you see one case of meningitis from an ear infection that wasn't treated - you're not willing to let it sit," he said.Tony Leys, staff writer
