Little antibiotic benefit in LRTIs
Cough lasts same time with antibiotics |
Antibiotics offer little benefit over no treatment in relieving the symptoms of acute lower respiratory tract infections, according to researchers
(JAMA 2005;293:3029).
Paul Little, primary care medical group, University of Southampton, and
colleagues studied 807 adults and children to estimate the effectiveness
of three prescribing strategies and an information leaflet.
Patients received either amoxicillin 250mg three times a day (or erythromycin
if allergic to penicillin) for 10 days, a prescription for delayed antibiotics
(patients were advised to collect it if their symptoms had not resolved
after 14 days) or no offer of antibiotics. In each group half the patients
received an information leaflet about the natural history of the illness
and the proposed prescribing strategy. Resolution of symptoms was assessed
via a patient diary.
The researchers say that compared with no treatment the other strategies
offered little benefit in terms of cough duration and severity; this
was still true for patients over 60 years old and those with green sputum
production. However, re-attendance rates within one month of consultation
were lower in the
antibiotic treatment groups compared with the third group (P=0.04).
“The use of delayed antibiotics or no antibiotics was acceptable,
resulted in little difference in duration or severity of symptoms compared
with
immediate treatment with antibiotics and considerably reduced both antibiotic
use and belief in antibiotics,” say the researchers.
Giving an information leaflet had no effect on symptom duration or severity
but increased re-attendance rates (P=0.02). |
The
Pharmaceutical Journal
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