Do delayed prescriptions reduce the use of antibiotics for the common cold? A single-blind controlled trial.
OBJECTIVE
To test the use of a delayed prescription compared with instructions to take antibiotics immediately in patients presenting to family physicians with upper respiratory tract infections (common colds).


METHODS
Randomized controlled single-blind study.


METHODS
Subjects were 129 patients presenting with the common cold who requested antibiotics or whose physicians thought they wanted them. All patients were in a family practice in Auckland, New Zealand, consisting of 15 physicians (9 male, 6 female) who had completed medical school between 1973 and 1992.


METHODS
Outcomes were antibiotic use (taking at least 1 dose of the antibiotic), symptom scores, and responses to the satisfaction questions asked at the end of the study.


RESULTS
Patients in the delayed-prescription group were less likely to use antibiotics (48%, 95% CI, 35%-60%) than were those instructed to take antibiotics immediately (89%, 95% CI, 76%-94%). Daily body temperature was higher in the immediate-prescription group. The lack of difference in the symptom score between the 2 groups suggests that there is no danger in delaying antibiotic prescriptions for the common cold.


CONCLUSIONS
Delayed prescriptions are a safe and effective means of reducing antibiotic consumption in patients with the common cold. Clarification of patient expectations for antibiotics may result in a lower prescription rate. When the patient demands a prescription, delaying its delivery has the potential to provide gentle education.
Arroll
B
B
Dept of General Practice & Primary Health Care, University of Auckland, Private Bag 92109, Auckland, New Zealand. b.arroll@auckland.ac.nz
Kenealy
T
T
Kerse
N
N
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001294:Attitude to Health; D003139:Common Cold / Q000188:drug therapy*; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D009520:New Zealand; D010818:Practice Patterns, Physicians'; D016037:Single-Blind Method; D013997:Time Factors
D000900:Anti-Bacterial Agents