Clinical Question What import do...

Clinical Question

What import does delayed prescribing of antibiotics have forward the clinical course of respiratory infections and the likelihood of complications?

Evidence-Based Answer

Delayed prescribing appears to be a reasonable and safe option in patients with cough and in those who do not appear self-same ill, but it cannot be make acceptableed for children with sore throat unles streptococcal pharyngitis has been rul public Delayed prescribing of antibiotics accrues in a small increase in symptoms in a certain groups of patients at day 3 However, this risk must be balanced against the benefits of fewer antibiotic side weights less antibiotic resistance, and lower cost

Practice Pointers

Delayed prescribing is the same strategy for reducing antibiotic use for used by all respiratory tract infections (RTIs). mostly of these infections are viral and do not benefit from the use of antibiotics. Delayed prescribing means giving patients a prescription still suggesting that they not fill it unles they begin to be excited worse or develop specific symptoms, or requiring that patients call the practice or pick up a prescription at a later date if their symptoms persist or worsen. A previous systematic review (1) showed that delayed antibiotic prescribing for RTIs lessens by one half the number of patients who take an antibiotic. In this review, Spurling and colleagues identified seven good-quality randomized controll trials that assigned patients to immediate or delayed antibiotics and followed them prospectively to determine their clinical outcomes

The studies included patients with sore throat, used by all cold, otitis media, and cough The ensues were mixed. In three studies of unselect children with sore throat (many of whom likely had streptococcal infection), patients in the delayed antibiotic assemblage were more likely to have a febrile affection on day 3. Findings were similar for pain and malaise: a certain quantity of studies found a benefit with immediate antibiotics, and a did not. Studies showing a benefit keeped to enroll sicker patients.

Delayed antibiotic prescribing ofttimes is used in adults with cough; alone one study considered this cluster and it found no difference in issues There were no consistent differences in reconsultation rates or complications between patients who received delayed treatment and those who received treatment immediately.

REFERENCE

(1) Arroll B Kenealy T Kerse N Do delayed prescriptions diminish antibiotic use in respiratory tract infections? A systematic review [published correction appears in Br J Gen Pract 2004;54:138] Br J Gen Pract 2003;53:871-7

MARK H EBELL, MD MS

Spurling G et al. Delayed antibiotics for symptoms and complications of respiratory infections. Cochrane Database Syst Rev 2004;(4):CD004417

COPYRIGHT 2005 American Academy of Family Physicians

COPYRIGHT 2005 Gale Group