Health Providers’ Advising on Symptom Management for Upper Respiratory Tract Infections: Does Elaboration of Reasoning Influence Outcomes Relevant to Antibiotic Stewardship?

Antibiotic-resistant infections, fueled by unwarranted antibiotic prescribing, are an increasing threat to public health. Reducing overprescribing and promoting antibiotic stewardship requires managing patient expectations for and understanding about the utility of antibiotics. One hotspot for overprescribing is upper respiratory tract infections, for which the best treatment is often non-antibiotic symptom management behaviors. Guided by advice response theory, the current study examines how providers’ reason-giving for symptom management advice affected perceptions of advice quality, efficacy for symptom monitoring and management, and satisfaction with care for patients who were not prescribed antibiotics for their upper respiratory tract infections. Transcribed medical visits were coded for symptom management advice reason-giving and patients completed post-visit surveys. Greater provider elaboration about instruction was independently and positively associated with evaluations of advice quality. Results also indicate several significant interactions between types of reason-giving. Implications of these findings for advice theory and clinical practice are addressed in the discussion.

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Outcome of upper respiratory tract infections in healthy children: Antibiotic stewardship in treatment of acute upper respiratory tract infections

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.4.1420 ◽

2020 ◽

Vol 36 (4) ◽

Author(s):

Ejaz Ahmed Khan ◽

Mazhar Hussain Raja ◽

Shehla Chaudhry ◽

Tehreem Zahra ◽

Salman Naeem ◽

...

Keyword(s):

Respiratory Tract ◽

Antibiotic Stewardship ◽

Respiratory Tract Infections ◽

Upper Respiratory Tract Infections ◽

Healthy Children ◽

Supportive Treatment ◽

Upper Respiratory Tract ◽

Upper Respiratory ◽

Tract Infections

Objective: The objective of the study was to assess the outcome of upper respiratory tract infections (URTI) in healthy children. Methods: This descriptive study was conducted on 314 children aged 3-36 months in the paediatric outpatient clinic and emergency department with symptoms of URTI (fever, cough, rhinorrhoea) for ≤5 days. Patient’s demographics, clinical features, laboratory data and outcome were recorded. Follow up phone calls were made to parents on day 7 (response 93.6%) and day 14 (response 94.6%) to record outcome. Results: A total of 314 children with URTIs were included. Majority (57.6%) were males and <1year of age (40%). Common manifestations of URTI were fever (89%), cough (79%), rhinorrhoea (62%), pharyngitis (79%) and conjunctivitis (46%). More than half (53%) had history of contact with URTI in a family member. Mean duration of symptoms was 2.7±1.3 days. Majority (93%) of children were given supportive treatment and only 6.7% received antibiotics initially. Most of children (76%) recovered within one week and 91.8% within two weeks with supportive care only. Only 4% children were hospitalized and 12% required follow up visit of which 16% needed oral antibiotics. Complications or deaths did not occur. Conclusions: Majority of URTIs in healthy children resolved with supportive treatment and do not require antibiotics. Antibiotic stewardship in simple URTIs should be practiced using awareness and advocacy campaigns. doi: https://doi.org/10.12669/pjms.36.4.1420 How to cite this:Khan EA, Raja MH, Chaudhry S, Zahra T, Naeem S, Anwar M. Outcome of upper respiratory tract infections in healthy children: Antibiotic stewardship in treatment of acute upper respiratory tract infections. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1420 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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