Latino and black children are less likely to be prescribed antibiotics inappropriately during emergency medical care, according to a new study published in the journal Pediatrics. But while fewer antibiotics, in general, is cause for celebration (scientists agree that the overprescription and misuse of antibiotics has led to the rise of drug-resistant bacteria) it turns out that minority kids may be getting fewer antibiotics than their white peers for all the wrong reasons.
“What’s most troublesome is the fact that these differences exist at all,” Dr. Monika Goyal, director of research in the Division of Emergency Medicine at Children’s National Health System, told Fatherly. “Shouldn’t everybody be receiving standard of care? Why are there differences at all by race and ethnicity?”
Goyal and her team looked into the records of 39,000 three-year-olds who were treated at pediatric ERs for viral acute respiratory infections. Since these infections are caused by viruses, antibiotics are an ineffective treatment. The researchers found that only 1.9 percent of black patients and 2.6 percent of Latino patients were erroneously prescribed antibiotics. White patients, however, received antibiotics 4.6 percent of the time—nearly double the rate of minorities.
“We were pleased that the rates of unnecessary antibiotic prescribing were low,” Goyal says. “But what surprised us was how dramatic the differences of antibiotic prescribing differed by race and ethnicity.”
For the researchers, it was the ultimate in good news/bad news result. One on hand, any decrease in the misuse of antibiotics is good thing. On the other hand, racial disparities in how the antibiotics are prescribed is likely not benign. Prior research suggests that race-related disparities exist in other medical treatments, and one recent study showed that Hispanic, Native American and Alaskan Native children across 134 California NICUs had lower “quality of care” scores.
It’s important to note that the California study did not conclude the discrepancy was due to racial bias. Neither does the Children’s National Health System study. It does, however, point to a need for more exploration.
One of the main reasons for physicians overprescribing antibiotics is due to pressure to honor parents’ misguided wishes. It is possible that physicians are taking the unwarranted concerns of white parents more seriously than that of minority parents. In that case, there would be a clear racial bias at play. Then again, minority parents are more likely to defer to physicians, which means they may be less likely to demand antibiotics even when a doctor says it won’t work.
“We’re looking into both implicit and explicit bias in clinicians,” explains Goyal. But there are also more possibilities include the treatment demands of parents. “Maybe there are differences in perception of when antibiotics are useful. And maybe it’s that when parents do make requests it’s more likely clinicians will listen to non-minority patients.”