Back-up antibiotic prescriptions could reduce unnecessary antibiotic use in rhinosinusitis

J Clin Epidemiol. 2004 Apr;57(4):429-34. doi: 10.1016/j.jclinepi.2003.09.008.

Abstract

Objectives: To examine the attitudes of patients with rhinosinusitis toward the availability of "back-up" antibiotics, and potential implications for antibiotic use rates.

Study design and setting: A survey that assessed actual and hypothetical antibiotic prescription patterns was administered to a convenience sample of patients treated for rhinosinusitis in one acute care facility between September 1 and December 1, 2001.

Results: Of 386 eligible patients, 114 completed the survey. Seventy-six percent of patients expected antibiotic treatment; satisfaction rates were significantly associated with receiving an antibiotic prescription (P <.05). Over two-thirds of patients (69.7%) reported preference for back-up antibiotic prescriptions in the future, with 91.1% stating they would wait at least 1 day, and 52.7% at least 7 days, to fill a backup prescription. In sensitivity analysis, back-up prescriptions significantly reduced antibiotic use over a wide range of assumptions.

Conclusions: The majority of patients with rhinosinusitis in this study expected antibiotic prescriptions, and were more satisfied if they were received. Back-up antibiotics have the potential to reduce unnecessary antibiotic use, mitigate risk of nontreatment, and preserve high levels of patient satisfaction.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage*
  • Child
  • Child, Preschool
  • Connecticut
  • Drug Utilization / statistics & numerical data
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Retrospective Studies
  • Rhinitis / drug therapy*
  • Sinusitis / drug therapy*
  • Unnecessary Procedures / statistics & numerical data*

Substances

  • Anti-Bacterial Agents