Antibiotics and respiratory infections: do antibiotic prescriptions improve outcomes?

Antibiotics are frequently prescribed for respiratory infections though most of these infections are viral. To determine whether this practice contributes to patient health and patient satisfaction, we studied the effect of antibiotic prescriptions on outcomes at 7 to 10 days. We also studied the effect of antibiotic prescriptions upon the accuracy of patients' beliefs about viruses.

One hundred thirteen patients with a respiratory infection completed questionnaires before and after their visit with their primary care doctor. A phone interview was completed 7 to 10 days later. Questions elicited their expectations for antibiotics, their beliefs about the efficacy of antibiotics, and satisfaction with the doctor. The phone interview asked whether they felt better, whether they had returned to the doctor about the same illness, satisfaction, and whether they would expect antibiotics for the same disease in the future. The doctors provided information about their diagnosis and treatment.

No correlation was found between prescription of antibiotics and patient satisfaction, feeling better, return physician visits, or phone calls. Receiving antibiotics increased the likelihood the patients would expect antibiotics the next time they had an upper respiratory infection and made them more likely to have an inaccurate belief, that antibiotics kill viruses.

The study found no evidence that antibiotics improve patient outcome in upper respiratory infections by making patients feel better at 7 to 10 days. Nor did it find evidence that antibiotics help physicians by reducing return visits or increasing patient satisfaction. Doctors are invited to reconsider their policies for prescribing antibiotics for upper respiratory infection.