More evidence of ineffectiveness will not reduce antibiotic prescribing for sore throat

Most doctors know that antibiotics do not help the great majority of sore throat sufferers and can cause harm. Yet antibiotics are commonly prescribed for this condition. Butler et al (p 637) attempted to understand this paradox by interviewing general practitioners and their patients, and found that preserving the doctor-patient relationship was often more important than evidence based prescribing. Patients seldom made their expectations explicit, and many did not have their wide ranging expectations met. Satisfaction was not necessarily related to getting antibiotics. Informing clinicians about trials showing that antibiotics are largely ineffective is unlikely to change prescribing patterns, but mounting evidence that unnecessary antibiotics may harm individuals might. Consulting skills that are brief, make expectations explicit, preserve relationships, and facilitate acceptable management are important.


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Relevant Article

Understanding the culture of prescribing: qualitative study of general practitioners' and patients' perceptions of antibiotics for sore throats
Christopher C Butler, Stephen Rollnick, Roisin Pill, Frances Maggs-Rapport, and Nigel Stott
BMJ 1998 317: 637-642. [Abstract] [Full Text] [PDF]

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