Are pediatricians adhering to principles of judicious antibiotic use for upper respiratory tract infections?

BACKGROUND: In 1997, the Centers for Disease Control and Prevention (CDC), in collaboration with other professional organizations, released principles for judicious use of antibiotics in pediatric upper respiratory illnesses (URI). This study compared use of antibiotics for URI in children before (1995) and after (1998) publication of the principles and compared survey responses with practice habits.

METHODS: A questionnaire was mailed to a sample of pediatricians in northern Virginia. Office records of a randomly selected subset of pediatricians were reviewed.

RESULTS: Seventy-five percent of pediatricians completed the questionnaire; 51/149 (34%) chose to prescribe antibiotics for purulent rhinorrhea of less than 10 days' duration. This was significantly lower than that reported in the 1995 survey. However, review of office records of a random sample of these pediatricians revealed no significant difference in antibiotic use in children with uncomplicated URI in the 2 years studied.

CONCLUSIONS: Injudicious antibiotic use for URI is prevalent among pediatricians in northern Virginia. Actual practice habits are at variance with response to case vignettes.