Antibiotics and Respiratory Infections: Are Patients More Satisfied when Expectations Are Met?

Background: Antibiotics are frequently prescribed for respiratory infections, even though most of these infections are viral. To understand why physicians do so, we studied patients' and physicians' expectations for antibiotics and the effects of the patient-physician interaction on patient satisfaction.

Methods: Patients with a respiratory infection were asked to complete a questionnaire before and after visiting with physicians at three family medicine centers. Physicians completed a questionnaire following the visit.

Results: Sixty-five percent of the 113 patients with respiratory infection expected antibiotics. Physicians had some ability to perceive this expectation and frequently prescribed antibiotics for patients who expected them. Antibiotics were prescribed to over 75% of patients with sinusitis or bronchitis and to 18% of those diagnosed with only viral infections. No association was found between a prescription for antibiotics and patient satisfaction; however, patient satisfaction did correlate with the patients' report that they understood the illness and that the physician spent enough time with them.

Conclusions: Physicians frequently prescribe antibiotics for upper respiratory infections when they believe patients expect it, but receiving a prescription for antibiotics is not in and of itself associated with increased patient satisfaction.