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Antibiotics for acute uncomplicated lower respiratory tract infection

According to the article published in The Journal of the American Medical Association, no offer or delayed offer of antibiotics for // acute uncomplicated lower respiratory tract infection (LRTI) is acceptable. Acute lower respiratory tract infection is a common complaint in the out patient departments and is one of the most common condition which is treated.

The randomized controlled trial was undertaken to assess the effectiveness on symptoms, beliefs, and behavior of three different antibiotic prescribing strategies and to assess the effectiveness of an information leaflet compared with brief verbal information alone. 807 patients who presented to the primary care setting between 1998 and 2003 with acute uncomplicated lower respiratory tract infection (LRTI) were randomly allocated into one of the six groups consisting of leaflet or no leaflet in the groups- immediate antibiotics, no offer of antibiotics, and delayed antibiotics. The outcome of the trial was measured in terms of symptom duration and severity. Seventy percent of them returned completed diaries and about 10% provided information on the symptom duration and severity. Cough rated as at least "a slight problem" lasted a mean of 11.7 days.

The results of the trial showed that the information leaflet had no effect on the main outcomes. Compared with no offer of antibiotics, other strategies did not alter cough duration or other primary outcomes. Compared with the group for whom immediate antibiotics were prescribed, fewer patients in the delayed and control groups used antibiotics, fewer patients were "very satisfied” and fewer patients believed in the effectiveness of antibiotics. The study concluded that no or a delayed offer of antibiotics for acute uncomplicated lower respiratory tract infection is quite acceptable. It was also associated with little difference in symptom resolution and is likely to reduce antibiotic use and beliefs in the effectiveness of antibiotics.'"/>




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