title: Antibiotics for upper respiratory tract infections. Follow-up utilization and antibiotic use.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Family Medicine, Medical University of South Carolina, Charleston, USA.
authors.forename: W J
authors.initials: WJ
authors.lastname: Hueston
authors.forename: A G
authors.initials: AG
authors.lastname: Mainous
authors.forename: S
authors.initials: S
authors.lastname: Ornstein
authors.forename: Q
authors.initials: Q
authors.lastname: Pan
authors.forename: R
authors.initials: R
authors.lastname: Jenkins
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000191:economics* / Q000821:virology; D012189:Retrospective Studies; D013022:South Carolina
chemical_list: D000900:Anti-Bacterial Agents