Prescribing Antibiotics Does Not Save Time

Clinical question: Does prescribing antibiotics for viral infections save time? Bottom line Prescribing antibiotics for respiratory infections in children does not improve patient satisfaction and, as shown in this study, doesn't save time. Of course, as you know, antibiotic prescribing also doesn't affect the duration or severity of these viral illnesses. (LOE = 2c)

Reference Coco A, Mainous AG. Relation of time spent in an encounter with the use of antibiotics in pediatric office visits for viral respiratory infections. Arch Pediatr Adolesc Med 2005;159:1145-49.
Study design: Cross-sectional Setting: Outpatient (primary care) Synopsis "If I don't give antibiotics, they won't be satisfied." "If I don't give antibiotics, they will change doctors." "If I don't give antibiotics, I will have to waste time explaining why." These are only a smattering of the excuses physicians use to justify bad practice. In this study, the authors used the National Ambulatory Medical Care Survey to evaluate the duration of visits for children presenting with colds or bronchitis. The survey, completed by physicians and office staff, includes an item labeled "time spent with a physician." The mean duration of the visits during which antibiotics were prescribed was 14.24 minutes; the mean duration of the visits when antibiotics were not prescribed was 14.18. Other studies have demonstrated that patient demand, patient satisfaction, and the likelihood of switching physicians are not affected by the receipt of an antibiotic. About the only thing prescribing antibiotics does is increase the likelihood of subsequent drug-seeking behaviors.