Nearly a third of antibiotics prescribed in doctors’ offices, emergency rooms and hospital-based clinics in the United States are not needed, according to the most in-depth study yet to examine the use of these life-saving drugs.

The finding, which has implications for antibiotics’ diminished efficacy, translates to about 47 million unnecessary prescriptions given out each year across the country to children and adults. Most of these are for conditions that don’t respond to antibiotics, such as colds, sore throats, bronchitis and the flu.

Although health officials have been warning for decades about the overuse of antibiotics and its contribution to the development of drug-resistant bacteria, the research from the Centers for Disease Control and Prevention and the Pew Charitable Trust is the first to quantify the depth of the problem.

The study published Tuesday in JAMA analyzed data for all antibiotic use in the three settings as collected from two major CDC surveys from 2010 to 2011. Antibiotic prescriptions written there represent the majority of dollars spent on antibiotics in health care in the U.S.