Although there may be some benefit of using antibiotics to treat the runny nose with colored discharge (acute purulent rhinitis), "their routine use is not recommended," the review says.

Colds are the most common reason for new patient visits at general practioners' offices, the review reports, and although the antibiotics do not work for that purpose, it is the second most common reason doctors prescribe them, Arroll writes.

"Physicians prescribe antibiotics in these cases out of habit and/or because they do not agree with the evidence," says Dr. Arroll. "Antibiotics do work for a minority of patients with purulent rhinitis, one out of five, so they may generalize this experience to their wider patient group."

Dr. Norman H. Edelman, chief medical officer for the American Lung Association, says, "There is no simple answer as to why providers do this. Some physicians may want to prevent complications of bacterial infections, which do occur. Some may be yielding to pressure from patients." But he says "this practice is on the decline as the public becomes more sophisticated about health issues."

Dr. Arroll says that patients are not doing themselves any favors looking for a "quick fix" in pressuring their providers to prescribe antibiotics for colds. "Patients will get a quicker fix if they take decongestants such as pseudoephedrine (Sudafed)," he says.

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Contact: Bruce Arroll
b.arroll@aukland.ac.nz
Center for the Advancement of Health
19-Jul-2005