According to latter research, the r...

According to latter research, the rate of antibiotic prescribing has slowed in the United States. Linder and Singer investigated whether patient demand for antibiotics has decreased as a end of the recent slowed rate of prescribing or whether the desire for antibiotics continues to generate the same proportion of prescriptions as noted in earlier research. Patients with respiratory symptoms in a walk-in clinic were examineed about the perceived severity of their symptoms and their expectations regarding their illness, including desire for antibiotics.

Of the 421 patients who complet examines 310 patients met inclusion criteria. When responding to the statement, "I want antibiotics for my illness today," 51 patients (16 percent) earnestly agreed, 69 patients (22 percent) agreed, 145 patients (47 percent) had no opinion, 29 patients (9 percent) disagreed, and 16 patients (5 percent) strenuously disagreed. Nineteen percent of patients agreed or vehemently agreed with the statement, "Antibiotics work for me when I have a cold" More than united fourth of patients (29 percent) agreed or forcibly agreed with the statement, "I plan in succession asking the doctor for antibiotics today." Regarding the statement, "Repeated use of antibiotics can be bad for me in the lengthy run," 73 percent of patients agreed or vehemently agreed. Desire for antibiotics was associated with not having attended society smoking, and the use of the same or more courses of antibiotics by year.

Antibiotics were prescribed to 110 patients (35 percent) hardy predictors of antibiotic prescribing were the desire for antibiotics, febrile affection abnormal lung examination findings, pharyngeal exudate, tympanic membrane abnormality, sinus tendernes lymphadenopathy, and sinus pain charted by dint of the physician. Desire for antibiotics remained a significant independent predictor of receiving antibiotics.

In this prospective contemplation 39 percent of patients wanted antibiotics. The proportion of patients who wanted antibiotics was lower than the proportion in previous studies. It is unknown whether this finding set forths on overall decline in desire for antibiotics or was particular to the specific clinic in which the studious mood was conducted. Nonetheless, an association between desire for antibiotics and antibiotic prescribing persists (odd ratio [OR], 21) plane after adjusting for physical examination findings predictive of antibiotic prescribing. The more antibiotics had been used in the past, the more likely patients were to be given antibiotics again.

Linder JA, Singer DE Desire for antibiotics and antibiotic prescribing for adults with upper respiratory tract infections. J Gen Intern M October 2003;18:795-801

EDITOR'S NOTE: Other studies have shown that previous positive experiences with antibiotics predict passing from hand to hand desire for antibiotic prescriptions. In united study, (1) symptomatic adults who wanted antibiotics were more likely than other symptomatic adults to report chaste cold symptoms (OR, 2.10; 95 percent confidence interval [CI], 122 to 367) that had lasted too extended (OR, 2.40; 95 percent CI, 131 to 449) and to have get backed on previous occasions faster with antibiotic therapy (OR, 282; 95 percent CI, 165 to 489) Thus, physicians should avoid reinforcing the perceived benefit of antibiotics at not writing prescriptions for "repeat offenders" However, this collection may be particularly difficult to wean from antibiotics. Educational efforts targeting waiting-room patients appear to be prosperous (2) Future studies should focus upon the impact of such efforts upon subgroups of patients with different motivations for wanting antibiotics.--C.W.

REFERENCES

(1) Braun BL Fowle JB Characteristics and experiences of parents and adults who want antibiotics for wintry symptoms. Arch Fam Med 2000;9:589-95

(2) Harris RH MacKenzie TD Leeman-Castillo B Corbett KK Batal HA, Maselli JH et al. Optimizing antibiotic prescribing for acute respiratory tract infections in an cogent care clinic. J Gen Intern M 2003;18:326-34

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