PMID: 9007559Jan 1, 1997Paper

Evidence-based management of upper respiratory infection in a family practice teaching clinic

Family Medicine
J A English, K A Bauman

Abstract

Management of upper respiratory infection (URI) was examined in a family practice clinic to determine evidence-based practices, specifically for medication choice. Scientific evidence supports the use of decongestants and perhaps decongestant/antihistamine combinations in adolescents and adults and antipyretics in all age groups. The use of cold preparations for children younger than age 5 is not evidence based. Data on demographics, medications prescribed, and over-the-counter medications recommended were collected from patient charts for 293 URI visits over a 6-month period. The cost of evidence-based URI treatment was compared with the cost of nonevidence-based treatment. Thirty-three percent of patients younger than age 5 were given a prescription; 96% of the prescription cost in this age group was nonevidence based. Twenty-six percent of all patients seen were given unnecessary and potentially harmful medication. These unnecessary medications accounted for almost 60% of the total prescription cost. Various combinations of antihistamines, decongestants, and antitussives were most commonly prescribed. Few medications have been shown to effectively alleviate the symptoms of the generally self-limited, benign common cold. Medi...Continue Reading

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