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Does clinical error contribute to unnecessary antibiotic use?

McIsaac, Warren J. and Butler, Christopher Collett 2000. Does clinical error contribute to unnecessary antibiotic use? Medical Decision Making 20 (1) , pp. 33-38. 10.1177/0272989X0002000104

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Patient expectations and physician attitudes are often cited as factors in the overuse of antibiotics. This study examined whether clinical error might also be important. In treating 517 patients with sore throat, family physicians estimated the probability that group A streptococcus infection was present. Two thirds of antibiotics prescribed were to culture-negative patients and therefore considered unnecessary. Physicians overestimated the probability that a group A streptococcal infection was present by an average 33.2% in these cases, compared with 6.9% otherwise (p < 0.001). The rate of unnecessary prescribing was 5.1% when the physician estimate differed from the true probability of a group A streptococcal infection by <10%, 16.0% for an error of 10-29%, 35.6% for an error of 30-49%, and 78.3% when the chance of the infection was overestimated by 50% or more. Clinical error in estimating the likelihood of group A streptococcal infection probably contributes to unnecessary antibiotic use in patients with sore throat.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: antibiotic use; clinical error; prescribing; sore throat
Publisher: SAGE Publications
ISSN: 0272-989X
Last Modified: 30 Jun 2017 03:30

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