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Research ArticleOriginal Research

Communication Practices and Antibiotic Use for Acute Respiratory Tract Infections in Children

Rita Mangione-Smith, Chuan Zhou, Jeffrey D. Robinson, James A. Taylor, Marc N. Elliott and John Heritage
The Annals of Family Medicine May 2015, 13 (3) 221-227; DOI: https://doi.org/10.1370/afm.1785
Rita Mangione-Smith
1Department of Pediatrics, University of Washington, Seattle, Washington
2Seattle Children’s Research Institute, Seattle, Washington
MD, MPH
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  • For correspondence: Rita.Mangione-Smith@seattlechildrens.org
Chuan Zhou
1Department of Pediatrics, University of Washington, Seattle, Washington
2Seattle Children’s Research Institute, Seattle, Washington
PhD
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Jeffrey D. Robinson
3Department of Communication, Portland State University, Portland, Oregon
PhD
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James A. Taylor
1Department of Pediatrics, University of Washington, Seattle, Washington
MD
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Marc N. Elliott
4RAND Corporation, Santa Monica, California
PhD
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John Heritage
5Department of Sociology, University of California, Los Angeles, Los Angeles, California
PhD
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The Article in Brief

Communication Practices and Antibiotic Use for Acute Respiratory Tract Infections in Children

Rita Mangione-Smith , and colleagues

Background Unnecessary use of antibiotics is associated with increased resistance in bacteria that commonly cause acute respiratory tract infections, posing risks to individuals and communities. This study examines relationships between clincians' communication practices, antibiotic prescribing, and parent care ratings during pediatric visits for acute respiratory infection.

What This Study Found When pediatric clinicians suggest actions parents can take to reduce their child's symptoms (positive treatment recommendations) and offer explanations of the inappropriateness of antibiotics for their child's infection (negative treatment recommendations), they are less likely to prescribe antibiotics and still maintain a positive care experience for patients. Analyzing surveys from patients and physicians after pediatric visits for acute respiratory tract infection symptoms, researchers found that providing positive treatment recommendations was associated with decreased risk of antibiotic prescribing whether done alone or in combination with negative treatment recommendations. Parents receiving combined positive and negative treatment recommendations were more likely to give the highest possible visit rating.

Implications

  • The combined use of positive and negative treatment recommendations may reduce the risk of antibiotic prescribing for children with viral infections and at the same time improve visit ratings.
  • With the growing threat of antibiotic resistance at the community and individual level, the authors assert, these communication techniques may assist frontline clinicians in helping to address this pervasive public health problem.

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