title: Self-reported prescribing of antibiotics for children with undifferentiated acute respiratory tract infections with cough.
abstract: BACKGROUND
  Physicians are often called on to manage children with acute respiratory tract infections with cough when the clinical presentation may not allow a differentiation between viral and bacterial etiology. To develop guidelines for appropriate antibiotic use, it is necessary to understand the present prescribing patterns of physicians who manage children presenting with such an undifferentiated acute respiratory tract infection with cough (UARTIC).
  
  
  OBJECTIVE
  To determine the variability of self-reported prescribing habits for antibiotics for children with UARTIC.
  
  
  METHODS
  In this cross-sectional survey by a modified Dillman's Total Design Method, a mail-out questionnaire was administered to a random sample of 181 primary care family physicians and pediatricians (Toronto, Ontario, Canada) to assess perceptions of their own antibiotic-prescribing habit.
  
  
  RESULTS
  Completed questionnaires were received from 136 (75%) eligible physicians; 32% reported that > 10% of their office visits were for UARTIC. For a 3-day history of UARTIC 24% reported prescribing antibiotics or antibiotics in reserve (i.e. a prescription to be filled if the patient's condition does not improve) always or most times. This increased to 45% when UARTIC had worsened in the 24 h before the office visit (P < 0.001).
  
  
  CONCLUSIONS
  When a pediatric patient presented with UARTIC, antibiotics or antibiotics in reserve were prescribed in the absence of clear indicators of bacterial infection. Research- and evidence-based guidelines are needed to support rational antibiotic use for UARTIC.
authors.affiliation: Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Davy
authors.forename: P T
authors.initials: PT
authors.lastname: Dick
authors.forename: P
authors.initials: P
authors.lastname: Munk
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D003371:Cough; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D005194:Family Practice / Q000639:trends; D006801:Humans; D009864:Ontario / Q000453:epidemiology; D010372:Pediatrics / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents