“Since 2005," Linder notes,"a Healthcare Effectiveness Data and Information Set measure for patients aged 18 to 64 years states that the antibiotic prescribing rate for acute bronchitis should be zero. Despite the evidence, meta-analyses, and performance measures, antibiotic prescribing for acute bronchitis in the United States remains at more than 70%.” He is critical of the Gonzales study because, even after its “statistically significant” intervention, “The antibiotic prescribing rate—an event that should never happen for these patients—in ‘successful’ intervention practices was still more than 60%. For individual clinicians…we need to redefine success. Success is not reducing the antibiotic prescribing rate by 10%; success is reducing the antibiotic prescribing rate to 10%.”
Or less. Many people will say “I got antibiotics and I felt better in a couple of days”. Almost all of these people would have gotten better anyway. There are some studies that show, in large populations, taking antibiotics can shorten symptoms by about a half-day. (This is probably because of some minor bacterial co-infection in some folks, especially those with chronic lung disease). But not by a week, or 2 or 3. Length of time of symptoms is not an indication for antibiotics for a viral illness. And that half day? Linder points out that “5% to 25% of patients who will have an adverse reaction. Worse, at least 1 in 1000 patients who take an antibiotic will wind up in the emergency department with a serious adverse drug event.” This is, to put it mildly, not good.