Use and Perceptions of Antibiotics for Upper Respiratory Infections Among College Students
Our study emphasizes the need for patient education to: (1) minimize the use of health services or self-limiting illnesses; (2) decrease the inappropriate use of antibiotics; and (3) promote increased selectivity in patients’ choices of nonprescription remedies (eg, promote the use of evidence-based remedies). The central role of the physician as educator and opinion leader in this process should not be overlooked. From previous research it remains unclear whether physicians really believe in the usefulness of antibiotics in treating URIs or whether they are responding to patient expectations. However, some findings indicate a continued need for physician education about the natural history of URIs. For example, Schwartz and colleagues11 surveyed family physicians and pediatricians in Virginia with a questionnaire describing case scenarios that involve a single-day history of greenish-yellowish discharge and low-grade fever. A majority of the physicians surveyed endorsed prescribing antibiotics. Another study revealed that physicians confronted with colored nasal discharge, lack of response to decongestants, and fever (among other symptoms) diagnosed sinusitis and prescribed antibiotics in more than 98% of cases and prescribed the same for more than 13% of patients with URIs.17 In a 1999 study, pediatricians and family physicians in Georgia reported prescribing practices that were inconsistent with published recommendations for judicious antibiotic use in the treatment of URIs, again overprescribing anitibiotics.18 Given such study results can we blame our patients’ for their enduring confidence in antibiotic effectiveness? Targeted educational information provided by trusted physicians and a refusal by physicians to prescribe unnecessary antibiotics are vital components in influencing our patients’ beliefs. Although some patients will obtain antibiotics without prescriptions,12 we can have a significant impact on the beliefs encouraging these practices. The ultimate responsibility for changing patient attitudes and prescribing habits of physicians remains with us.
Limitations
Participants in this self-report survey were volunteers, which may introduce a selection bias. Also, because current college students composed the study population, the ability to extrapolate these findings to other young adults, college-educated older adults, or adults in general is unknown.
Conclusions
Our results show that health care education is needed among college students, especially in the area of symptoms and treatments of common illnesses. Educational interventions for patients and physicians concerning the presentation of the common cold and the appropriate use of antibiotics should be the focus of continuing research. This may result in more medical resources and less-resistant organisms.
