Can reduce antibiotic use in acute respiratory infections

Although a reduction has occurred in the use of antibiotics for upper respiratory tract infections, international evidence indicates that they continue to be used for these conditions.1 This is in spite of Cochrane reviews indicating minimal or no benefit from antibiotics for sore throat, acute bronchitis, the common cold, and otitis media. This situation of potentially inappropriate prescribing prompted one commentator to suggest the use of delayed prescriptions (also known as “back-pocket,” “back-up,” or “as needed” prescriptions).2 These are prescriptions written with a proviso that they not be used immediately and only if symptoms do not improve.

The first randomised trial of delayed prescriptions for respiratory symptoms was undertaken by Little et al (1997), who gave antibiotics, with the prescription to be filled immediately or after three days, or no antibiotics for acute sore throat.3 The immediate group filled 99% of the antibiotic prescriptions whereas …