• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Infectious Disease

Delayed antibiotic prescribing is a safe and effective for respiratory tract infections in a community setting

byJessie WillisandTeddy Guo
May 14, 2021
in Infectious Disease, Preclinical, Pulmonology
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. There was no difference in follow-up symptom severity between patients who received immediate or delayed antibiotics for respiratory tract infections.

2. Delaying antibiotics was associated with higher patient satisfaction, lower complications, and fewer reconsultations compared to not receiving any antibiotics. 

Evidence Rating Level: 1 (Excellent) 

Study Rundown: In 2016, the CDC estimated that 30% of antibiotics prescribed in the US were unnecessary. This is especially a concern for upper respiratory tract infections, where evidence around antibiotic use remains controversial. Delayed prescribing, or waiting to fill the prescription after initial consultation, is a potential strategy to lower the risk of antibiotic resistance and unnecessary drug side effects. In this systematic review and individual patient data meta-analysis, the effect of delayed prescribing on symptom severity in respiratory infections was studied. Nine RCTs and four observational studies were included in the individual patient data meta-analysis, most of which were in the context of primary care. Based on a 7-point scale taken two to four days after initial consultation, no difference was found in follow-up symptom severity between delayed versus immediate antibiotics or between delayed versus no antibiotics. Secondary outcomes included a slightly longer disease duration for the delayed group versus the immediate group. Recorded hospital admissions and deaths were lower in the delayed versus comparison groups. There were also significantly lower reconsultation rates and increased patient satisfaction in the delayed versus no antibiotic group. The study adjusted the data for duration of previous illness, fever, comorbidity and severity and found no change in effectiveness. However, age had a significant effect on the results, with children younger than five having more severe symptoms with delayed versus immediate antibiotics. Limitations of this study include its lack of external validity to a non-primary care practice, for example in severe ICU cases with sepsis. Nonetheless, this review provides strong evidence that delayed prescribing is a safe strategy for mitigating antibiotic overuse in a community setting, except in children under five years of age.

Click to read the study in BMJ

Relevant Reading: Understanding the delayed prescribing of antibiotics for respiratory tract infection in primary care: a qualitative analysis

RELATED REPORTS

Oral gepotidacin is non-inferior to standard therapy for uncomplicated urogenital gonorrhea

Risk of bloodstream infections with indwelling peripheral catheters increase after 3 days

#VisualAbstract Seven Days of Antibiotic Treatment Non-inferior to 14 Days for Bloodstream Infections

In-Depth [systematic review and meta-analysis]: In this study, data was collected from nine RCTs and four observational studies, totaling 55 682 patients, mostly in a primary care setting. Aggregate data from five RCTs (n = 930) that did not have individual patient data was also included. The mean age was 38.7 years and subgroup effects, such as fever, age, duration of previous illness, lung disease, and baseline severity were also analyzed. A two-stage approach was used to classify the symptom severity on a seven-point scale (normal to as bad as could be). Adjusted data from eight studies showed no difference in follow-up symptom severity between delayed versus immediate antibiotics (adjusted mean difference -0.003, 95% CI -0.12 to 0.11). Adjusted data from seven studies showed no difference in symptom severity between delayed versus no antibiotics (adjusted mean difference 0.02, 95% CI -0.11 to 0.15). Subgroup analysis showed that age had a significant effect on the results, as children younger than five had more severe symptoms with delayed antibiotics versus immediate (adjusted mean difference 0.10, 95% CI 0.03 to 0.18). Secondary outcomes included slightly longer symptom duration in delayed versus immediate (11.4 vs. 10.9 days). For delayed antibiotics versus no antibiotics, there were lower reconsultation rates (odds ratio [OR] 0.72, 95% CI 0.60 to 0.87), fewer complications leading to hospital admission or death (OR 0.62, 95% CI 0.30 to 1.27), and higher patient satisfaction.

Image: PD

©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: antibioticantibiotic resistanceantibioticsrespiratory infectionsupper respiratory tractupper respiratory tract infections
Previous Post

#VisualAbstract Phase 2 trial shows combined oral 5-azacytidine and romidepsin are efficacious in treating peripheral T-cell lymphoma

Next Post

2 Minute Medicine Rewind May 17, 2021

RelatedReports

Nearly Half of All Pediatric Buprenorphine Exposures Result in Hospitalization
Infectious Disease

Oral gepotidacin is non-inferior to standard therapy for uncomplicated urogenital gonorrhea

May 28, 2025
Quick Take: Gentamicin compared with ceftriaxone for the treatment of gonorrhoea (G-ToG)
Hematology

Risk of bloodstream infections with indwelling peripheral catheters increase after 3 days

April 28, 2025
#VisualAbstract Seven Days of Antibiotic Treatment Non-inferior to 14 Days for Bloodstream Infections
StudyGraphics

#VisualAbstract Seven Days of Antibiotic Treatment Non-inferior to 14 Days for Bloodstream Infections

March 26, 2025
The 2 Minute Medicine Podcast Episode 15
2MM Podcast

The 2 Minute Medicine Podcast Episode 54

March 21, 2025
Next Post
Adalimumab aids in control of noninfectious uveitis

2 Minute Medicine Rewind May 17, 2021

Elevated systolic blood pressure is associated with left ventricular remodelling in adults born preterm

Increased severe maternal morbidity with multiple gestation pregnancies

Maternal weight gain and pregnancy outcomes in twin gestations

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • SGLT2 inhibitors may delay cognitive impairment in elderly patients with heart failure
  • Nerandomilast slows decline in FVC in idiopathic pulmonary fibrosis
  • Mazdutide significantly reduces weight in adults with overweight or obesity
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.