Parents will take explanation over antibiotics

Doctors who offer tips for alleviating children's cold symptoms will have happier patients and fewer prescriptions, a study says.

By Victoria Stagg Elliott, AMNews staff. May 24/31, 2004.

In response to numerous campaigns urging more judicious use of antibiotics, many doctors have just been saying no -- or at least trying to.

But telling a patient, "no antibiotics for you" might not be an effective way to cut unnecessary prescriptions, said a study presented at the Pediatric Academic Societies annual meeting in San Francisco this month.

The paper suggested that a more positive approach with suggestions of what could be done, rather than the negative, no-prescription mantra, might be a better way to cut down the number of antibiotics prescribed.

"It's much better to focus on what you can do than what you're not going to do," said Rita Mangione-Smith, MD, MPH, lead author and assistant professor of pediatrics at the Mattel Children's Hospital at the University of California, Los Angeles. "The take-home message is to really recognize that the child is sick, and here are some things we can offer to help, even if it's just symptomatic stuff."

Researchers videotaped more than 500 encounters between pediatricians and parents who brought their child in because of cold symptoms. Parents were more likely to disagree with physicians who focused on the fact that antibiotics should not be prescribed, and this disagreement seemed to result in more prescriptions. Satisfaction with care was not affected by whether the parent received an antibiotic prescription or not. But it was affected by whether physicians gave recommendations to alleviate the child's symptoms.