The vast majority of doctors practice years behind the evidence, but pediatricians seem to be the worst of the lot.
And this is not based just on my opinion; there are multiple research studies supporting this stance. Take the instance of antibiotics. For well over a decade now, researchers have been almost screaming about stopping the overuse of antibiotics. When the recommendations never seemed to reach the doctors, public health officials took the message directly to the patients.
Then there is the issue of using acid-blocking drugs in infants. Research has found that almost none of the prescriptions written were evidence-based.
Most pediatricians are militant about vaccinations. Yet, if you ask them about things like the Th2 cytokine shift, true effectiveness of vaccinations, duration of immune responses to specific vaccinations and whether or not we even need some vaccinations (hepatitis B in a newborn, for example) they are not aware of these concepts.
Interestingly enough, it seems like this disconnect with the medical literature only runs one way; many physicians seem very ready to adopt the information given by the drug companies while staying oblivious to the actual research on drugs and vaccinations. The adoption of drugs for uses that are off-label is lightning fast when compared to how long it takes for physicians to stop using these same drugs when future evidence finds that the drugs were either unsafe or not effective.
This particular study just feeds the idea the prescribing practices in 2313 pediatric patients of 46 general practices in southwestern France. Here’s what they found:
- 85% (1960) were exposed to at least one prescribed drug.
- Among children with prescriptions, 37.6% were given at least 1 off-label prescription.
- 6.7% of the medicated kids were given at least 1 unlicensed drug.
- The off-label prescribing involved an unapproved indication (56.4%), a lower dosage (26.5%) or higher dosage (19.5%) than specified, age not labeled (7.2%), incorrect route of administration (3.5%) and contraindication (0.3%).
I think the most shocking thing about this study is the very high percentages of kids that were given medications. Are our kids really that sick that the bulk of them need to have a medication for what they were presenting for? Are there so few situations where reassurances and simple recommendations are enough?
Beyond this concern, the off-label use was over a third. Not being a physician who writes prescriptions (and therefore could be wrong), the only route I can see the idea of off-label uses getting promoted is via the drug companies themselves. Since these uses are generally not in peer-reviewed medical literature, the information has to come from other sources.
If this is the case, then you are leaving your child’s health in the hands of the drug companies. Not something I would be willing to do.