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Antibiotics for Upper Respiratory Tract Infections
Follow-up Utilization and Antibiotic Use
William J. Hueston, MD;
Arch G. Mainous III, PhD;
Steven Ornstein, MD;
Qin Pan, MS;
Ruth Jenkins, MS
Arch Fam Med. 1999;8:426-430.
Objectives To examine the effects of antibiotic prescribing during an initial visit for viral respiratory tract infections on future care seeking and the cost of care.
Materials and Methods Retrospective analysis of recorded visits for viral respiratory tract infections (N=49,862) between January 1, 1995, and December 31, 1997, to practices in a large network of affiliated practices that use the same electronic medical record.
Results Patients receiving antibiotics at the initial visit were less likely to return for a second visit, but this difference was small (15.4% vs 17.4%, P<.001). When returning for the second visit, those who received an antibiotic on the initial visit were prescribed more expensive antibiotics than those who had not received an antibiotic on the initial consultation. Overall, cost from initial antibiotic use outweighed any benefit from reduced utilization in adults and children.
Conclusions Antibiotic prescribing at an initial contact for a viral respiratory tract illness may reduce the likelihood that an individual will return for a subsequent visit, but adds substantial costs to care for the initial antibiotic and for more expensive antibiotics used on subsequent visits.
From the Department of Family Medicine, Medical University of South Carolina, Charleston.
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