Prescribing antibiotics to patients with acute cough and otitis media

[摘要] The question of unnecessary antibiotic prescription is still in focus, both in Europe and other parts of the world. Studies have demonstrated that there is more than a threefold difference in prescribing rates between countries, without any good reason to explain the variation.1 Respiratory tract infections (RTIs) are the reason for 60% of all antibiotic prescribing in general practice and seem to be target conditions where antibiotics can be reduced most without increasing complications. Guidelines emphasise the need both for total reduction and increasing use of narrow spectrum antibiotics. A close relationship between use of antibiotics and resistance has been demonstrated for the most common airway pathogens, especially pneumococci.1,2 The dilemma in clinical practice is this: we know that we generally overprescribe and that's bad for everyone. At the same time we know that a small number of patients with RTI or otitis media will, if given antibiotics, benefit with shorter illnesses, and a tiny number potentially with fewer complications. So far there is little evidence of how to select patients for whom we should be prescribing.

[学科分类] 卫生学