Journal review - Antibiotic prescribing for patients with colds, upper respiratory tract infections, and bronchitis: A national study
March 1, 2001 2 minutes read
Journal review
Stone S, Gonzales R, Maselli J, et al. Antibiotic prescribing for patients with colds, upper respiratory tract infections, and bronchitis: A national study of hospital-based emergency departments. Ann Emerg Med 2000: 36:320-327.
Even though they are usually ineffective, antibiotics still are commonly prescribed for ED patients with upper respiratory tract infections, says this study from the University of Colorado Health Sciences Center in Denver. Using data from the 1996 National Hospital Ambulatory Medical Care Survey, performed by the National Center for Health Statistics in Hyattsville, MD, antibiotic prescribing rates were examined for 2.7 million ED visits for colds, upper respiratory tract infections, and bronchitis. The study found antibiotics were prescribed for 24.2% of patients with common colds and upper respiratory tract infections and for 42.2% of patients with bronchitis.
The researchers recommend ED clinicians and managers develop and implement strategies for more judicious use of antibiotics. "Unless we curtail our use of antibiotics, we face the prospects of higher costs, increased morbidity, and higher rates of death from common bacterial infections," they wrote. They recommend:
- giving patients "over-the-counter" prescription pads that educate patients about effective cold and cough preparations;
- emphasizing careful diagnosis of upper respiratory syndromes, deferral of antibiotic use, and a "watch-and-wait" approach for common colds, purulent rhinitis, and acute cough illnesses;
- participating in the development of clinical guidelines to promote judicious antibiotic use, possibly including computer-assisted decision supports and physician practice profiling;
- encouraging use of influenza and pneumococcal vaccines for patients in high-risk groups;
- distributing educational materials to providers and patients, such as brochures developed by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics.
[Editor’s note: Small quantities of educational materials on appropriate antibiotic use are available at no charge from the CDC, including brochures titled A New Threat to Your Health Prescription Pad, which is a checkoff list for symptomatic therapy for upper respiratory infection, and Q&A Sheet on Antibiotic Resistance. Materials also can be ordered from the CDC’s Web site: www.cdc.gov/antibioticresistance. Click on "Materials for Health Care Providers." Bulk quantities also may be obtained through the Public Health Foundation, which has a link from the CDC Web site. If you don’t have access to the Web, contact Lisa Bridges at the CDC. Telephone: (404) 371-5377. Fax: (404) 371-5434.
The American Academy of Pediatrics has a book titled The Principles of Judicious Use of Antimicrobial Agents: A Compendium for the Health Care Professional (Item No. MA0114). Copies are $34.95 plus $7.50 shipping and handling. A brochure titled Your Child and Antibiotics (Item No. HE0219) is available in English and Spanish in pads of 100. The cost is $34.95 plus $7.50 shipping and handling. To order, contact AAP, P.O. Box 747, Elk Grove Village, IL 60009-0747. Telephone: (888) 227-1770 or (847) 434-4000. Fax: (847) 228-1281. E-mail: [email protected]. Web: www.aap.org. Click on "Publications," then "AAP BookStore," then "New and Most Requested Topics" and scroll down to the brochure’s name.]
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