The Cochrane Library have published a review to assess if written information for patients (or parents of child patients) reduces the use of antibiotics for acute upper respiratory tract infections (URTIs; colds, sore throats, coughs or ear aches).
Most colds, sore throats, coughs and earaches are caused by viruses. Although antibiotics do not work against viruses, they are sometimes prescribed.
The researchers wanted to find out if giving written information about antibiotics immediately before or during doctor visits, together with usual care, changed antibiotic use compared with the doctor’s usual practice or something else.
They also wanted to know if: patients would be more likely to return to their doctor; symptoms would improve sooner; patients’ knowledge about antibiotics would improve; patients were satisfied with their doctor’s care; and if complications occurred.
The research criteria included randomised controlled trials (RCTs) involving patients (or parents of child patients) with acute URTIs, that compared written patient information delivered immediately before or during prescribing, with no information. RCTs needed to have measured the primary outcome (antibiotic use) to be included.
The researchers identified two studies that met their criteria. Both studies only recruited children.
One involved 558 children who were recruited from 61 general practices in England and Wales; and another of 269 doctors who provided data on 33,792 patient-doctor consultations in Kentucky, USA. Participants were children accompanied by an adult.
One study trained general practitioners (GPs) to discuss written information with parents, and in the other, doctors distributed copies of government-sponsored pamphlets to parents.
They key conclusions of the review were that providing a booklet and explanation by a specially-trained doctor reduced the number of antibiotics children consumed by 20% (from 42% to 22%) without affecting parent satisfaction with consultation or numbers of return visits for the same illness.
Compared to the doctor’s usual practice, two studies showed that providing a booklet reduced the proportion of children prescribed an antibiotic by 9% to 21%.
When doctors were also given feedback on their antibiotic prescribing along with providing a booklet to parents, the proportion of children prescribed an antibiotic increased by 6% (from 44% to 50%).
None of the included studies assessed if people were better informed, how long symptoms lasted, or if people had complications.
You can read the full review here.
O’Sullivan JW, Harvey RT, Glasziou PP, McCullough A. Written information for patients (or parents of child patients) to reduce the use of antibiotics for acute upper respiratory tract infections in primary care. Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD011360. DOI: 10.1002/14651858.CD011360.pub2.