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

• Published in: Journal of clinical epidemiology Vol. 57; no. 4; pp. 429 - 434
• Main Authors: Martin, Corey L, Njike, Valentine Yanchou, Katz, David L
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2004; Elsevier; Elsevier Limited
• Subjects: Acute Disease; Acute sinusitis; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; Antibiotics; Back-up prescriptions; Biological and medical sciences; Child; Child, Preschool; Connecticut; Drug Utilization - statistics & numerical data; Ent. Stomatology; Epidemiology; Female; Humans; Infant; Male; Medical sciences; Middle Aged; Non tumoral diseases; Otorhinolaryngology. Stomatology; Patient Satisfaction; Pharmacology. Drug treatments; Physicians; Practice Patterns, Physicians' - statistics & numerical data; Prescriptions; Retrospective Studies; Rhinitis - drug therapy; Risk reduction; Sensitivity analysis; Sinusitis - drug therapy; Survey; Unnecessary Procedures - statistics & numerical data; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Connecticut; Survey; Back-up prescriptions; Patient satisfaction; Antibiotics; Prescriptions; Acute sinusitis; Human; Nose disease; Rhinitis; Acute; Satisfaction; Sinusitis; Antibiotic; Chemotherapy; Treatment; Surveillance; Medical prescription; ENT disease; Paranasal sinus disease; Antibacterial agent
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/j.jclinepi.2003.09.008

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