95 Antibiotics And Upper Respiratory Infections

Lino Ganbarelli
Aims The objective of this study was to identify the reasons who determine antibiotic’s use in viral infection of upper respiratory tract in contrast of lack of any clinical benefit.
Design Observational prspective study
Method For a period of 5 months, five General Practitioners registered the contacts due to infections of upper respiratory tract of viral origin (clinical diagnosis). It was reported the prescription at the end of the consultation and, in case of antibiotics use, the clinic or extra-clinic reason for these therapeutic decision.

Five reasons was contemplated:
1. Clinical compromised state of the patient (from physician judgement)
2. Patient’s insistence for obtain antibiotic
3. Physician’s perception of patient’s expectation of receive antibiotic
4. Lack of time for patient’s information by physician about the inutility of antibiotic
5. Any others reasons.
Results 1330 patients attend surgery for a VURI during the 5 month of observation. 276 received an antibiotic at the end of the consultation (20%). The reason was, in 146 cases the clinical condition on the patient. In 58 cases the patient’s expectation (perceived by the physician) of obtaining antibiotic. In 36 cases the insistence by the patient. In 12 cases the lack of time during the consultation for accurately informing the patient about the uselessness of antibiotic. In 24 cases others reasons was adduced for antibiotic’s use .
This study confirm that despite the evidence of antibiotic’s uselessness in VURI, in the daily work GP uses this treatment in many situations. A most rational use of antibiotics is necessary but, for obtain this goal, many factors should be considered, first of all the elements concerning the patient’s expectation and his relations with the physician.
95 Antibiotics and Upper Respiratory Infections