[Overuse of antibiotics with upper respiratory tract infections in a primary care clinic].
In the majority of cases upper respiratory tract infections (URI's) are caused by viruses. Nonetheless, in many instances, patients with URI's are over-treated with antibiotics. In order to evaluate the use of antibiotic therapy in patients with URI's, we recorded medications prescribed for URI's in 394 young adults seeking care in a primary care clinic. The following parameters were assessed: rhinnorhea, cough, sore throat, dysphagia, tonsillar exudates, tonsillar enlargement and cervical lymphadenopathy. Throat cultures were taken from all the patients.


RESULTS
Antibiotic therapy was prescribed for 99 of the 370 patients (26.8%) with URI's and negative throat cultures. Among these patients, a high prevalence of the following findings was evident: tonsillar enlargement (66.7%), tonsillar exudates (48.5%), cervical lymphadenopathy (42.4%), lack of rhinorrhea (40.4%), lack of cough (32.0%) and fever (31.3%).


CONCLUSIONS
Excess antibiotic therapy was prescribed for patients with URI's. Possible explanations are: clinical findings that suggest a diagnosis of follicular tonsillitis, early antibiotic treatment that is not based on throat cultures or antigen detection tests, and multiple treating physicians.


CONCLUSIONS
We recommend that in cases of patients with URI's, antibiotics should not be prescribed unless diagnosis of a streptococcal infection is supported by results of throat cultures or antigen detection tests. Furthermore, in primary care clinics with a number of physicians, treatment should guarantee appropriate medical follow-up.
Cohen
A D
AD
Infectious Diseases Institute, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba.
Reuvni
H
H
Goldstein
N
N
Alkan
M
M
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003371:Cough / Q000188:drug therapy; D005260:Female; D005334:Fever / Q000188:drug therapy; D006801:Humans; D008297:Male; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D019966:Substance-Related Disorders; D014069:Tonsillitis / Q000188:drug therapy
D000900:Anti-Bacterial Agents