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Editorials |

Limiting Antibiotic Use in Lower Respiratory Tract Infections: Have We Gone Too Far?

Grant W. Waterer, MBBS
Author and Funding Information

Correspondence to: Grant W. Waterer, MBBS, School of Medicine and Pharmacology, University of Western Australia, Royal Perth Hospital, GPO Box X2213, Perth, WA 6847, Australia; e-mail: gwaterer@meddent.uwa.edu.au


Dr. Waterer is Associate Professor of Medicine, School of Medicine and Pharmacology, University of Western Australia, Royal Perth Hospital.

The author has reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;135(5):1118-1120. doi:10.1378/chest.08-3006
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Extract

Efforts to curb excessive antibiotic use have been pursued in many Western countries over the past few decades in response to the growing problem of antibiotic resistance in common bacteria. Education campaigns have quite sensibly tried to convince both doctors and the general public that antibiotics are not always required, especially in the treatment of respiratory tract infections, given that etiologic studies show a large proportion are due to viral pathogens.

In this issue of CHEST (see page 1163), the analysis of a large general practice database in the United Kingdom by Winchester and colleagues1 suggests that limiting antibiotic use in the treatment of lower respiratory tract infections (LRTIs) in the general practice setting may be having significant adverse consequences on patient outcomes. This study was in part prompted by other research2 in the United Kingdom suggesting that the prescription of antibiotics in the setting of an LRTI reduces the risk of subsequent pneumonia. Although 86% of patients identified by Winchester and colleagues1 were prescribed an antibiotic when presenting to a general practitioner with an LRTI, the 14% who did not had a threefold increase in respiratory infection-related mortality.

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