Antibiotics for upper respiratory tract infections and conjunctivitis in primary care
BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7563.311 (Published 10 August 2006) Cite this as: BMJ 2006;333:311All rapid responses
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I personally believe in delayed prescribing.
The point which I want to raise is how can we implement this in daily
practice? Because of age old tradition of antibiotic prescribing,
everybody who has a cough a cold will be getting antibiotics. If we start
implementing delayed prescribing 9 out of 10 patients will not be
satisfied. In this age of patient centered care and satisfying them, how
are we able to bring about the change and satisfy them?
So what I want to point is how can we make this information more
available to the public and change their way of thinking about
antibiotics? I think this is a point which needs a debate.
Competing interests:
None declared
Competing interests: No competing interests
I wholeheartedly agree with the author that antibiotics are
frequently unnecessary for conjunctivitis in children, which is often self
-limiting. In general practice however, we are frequently driven by the
demands of nurseries that antibiotics be presribed before the child can be
readmitted. To refuse or delay treatment often results in a parent having
to stay home from work to care for the child. This begs the question: how
important is it to treat the index case to prevent spread to other
children?
Justine Foster
Competing interests:
None declared
Competing interests: No competing interests
Re: Antibiotics for upper respiratory tract infections and conjunctivitis in primary care
It is true that no antibiotic, intended to oppose growth of bacteria, is indicated for a treating viral syndrome, but common experience shows that an antibiotic will often diminish symptoms of, and speed recovery from what one assumes is a viral cold or flu. The likely benefit is in opposing a bacterial superinfection of a viral syndrome. There is no clear, definitive test to determine the presence of a bacterial superinfection, as results of, say, a sputum culture, can be equivocal. Treating "a virus" with an antibiotic fits into the long and venerable tradition of the therapeutic trial. If, in response to treatment with an antibiotic, the supposedly viral symptoms abate, the diagnosis, in retrospect, is bacterial superinfection of a presumed viral syndrome and, the sooner the patient begins taking the course of antibiotic, the sooner his symptoms may abate.
Competing interests: No competing interests