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Am Fam Physician. 2006;73(7):1253

Clinical Question: Does prescribing antibiotics for viral infections save time?

Setting: Outpatient (primary care)

Study Design: Cross-sectional

Synopsis: Many physicians fear that if they do not prescribe antibiotics they will lose patients to other doctors or they will have to spend time explaining to patients why an antibiotic is unnecessary. In this study, the authors used the National Ambulatory Medical Care Survey to evaluate the duration of visits for children presenting with colds or bronchitis. The survey, completed by physicians and office staff, included an item labeled “time spent with a physician.” The mean duration of the visits during which antibiotics were prescribed was 14.24 minutes; the mean duration of the visits when antibiotics were not prescribed was 14.18 minutes.

Other studies have demonstrated that patient demand, patient satisfaction, and the likelihood of switching physicians are not affected by the receipt of an antibiotic; however, prescribing antibiotics does increase the likelihood of subsequent drug-seeking behaviors.

Bottom Line: Prescribing antibiotics for respiratory infections in children does not improve patient satisfaction, does not save time, and does not affect the duration or severity of viral illnesses. (Level of Evidence: 2c)

POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, editor-in-chief.

A collection of POEMs published in AFP is available at https://www.aafp.org/afp/poems.

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