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Study: Antibiotics often unnecessary but make patients happy

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(MedPage Today) -- When people leave a doctor's office after being seen for a cough they feel better immediately if they are clutching a little piece of paper that a druggist will exchange for a bottle of antibiotics.

The patient is happy, the druggist is happy, and the doctor has mixed feelings. What the doctor knows -- and most patients refuse to accept -- is that the antibiotics probably have no bearing on the course of the cough. The cough will get better at its own pace, antibiotics notwithstanding

People don't like it when doctors nod their heads wisely and send them on their way. They want antibiotics, and if the doctor won't write a prescription the patient will find a doctor who will. Doctors don't want to lose patients, so they write prescriptions.

This was the bottom line of a study reported Tuesday in the Journal of the American Medical Association. It found that antibiotics make patients happy even though they don't shorten the duration of cough, congestion or general malaise from lower respiratory tract infections.

Although the antibiotics didn't help patients, the patients thought they did, and they were satisfied with their treatment even though they kept coughing for up to a month, reported Paul Little M.D., of the University of Southampton in England, and colleagues.

The downside of taking the antibiotics? For one thing, people are paying for something they don't need. And for another, when people really need antibiotics the bugs may have developed resistance to them, in effect because of too much familiarity.

Ditto on needless antibiotics for children with conjunctivitis, the infamous pink eye that is so contagious. Conjunctivitis, too, seems to get better on its own, with or without antibiotic eye drops, said another study published Tuesday in another medical journal, The Lancet.

There was no significant difference in the recovery rate between 163 children treated with antibiotic eye drops and 163 given dummy drops, Peter W. Rose, M.D., of the University of Oxford, and colleagues reported.

After seven days, the pink eye of 86 percent of those in the antibiotic group had healed, versus 83 percent in the placebo group. The children were ages 6 months to 12 years. "Parents should be encouraged to treat children themselves [with topical lubricants] without medical consultation, unless their child develops unusual symptoms or symptoms persist for more than a week," said Dr. Rose.

One hang-up here, though, is that daycare centers and schools may require 24 hours of antibiotic eye-drop therapy before allowing the children to return.

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