NIHR Signal - A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use

AntibioticsDelaying antibiotic prescribing made little difference to most symptoms of respiratory infection. It reduced antibiotic use and did not affect patient satisfaction compared with immediate prescribing of antibiotics.

Increasing antibiotic resistance is a global health concern. Many people donít realise that viruses cause most respiratory infections and that antibiotics wonít help. The strategy allows some time for symptoms to improve naturally.

This review of the latest evidence on delayed prescribing for self-limiting respiratory infections is in line with current guidance. On the whole delaying antibiotics made little difference to symptoms compared with immediate use although certain symptoms, like malaise and fever in sore throat, might last a bit longer.

The 11 studies differed widely by patient populations, delay strategies, antibiotics given and settings. This makes it difficult to draw firm conclusions on where delayed prescribing is most appropriate.

Nevertheless delaying antibiotics seems a worthwhile strategy to reduce antibiotic use.

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