Injudicious antibiotic use: an unforeseen consequence of the emphasis on patient satisfaction?

BACKGROUND: Antibiotic resistance is an increasingly serious problem in the United States and many other parts of the world. One of the causes is the injudicious prescribing of antibiotics for self-limited viral infections. Physicians often cite parent and patient pressure as factors in their decisions to prescribe antibiotics for viral upper respiratory tract infections.
OBJECTIVE: This article draws from the literature to determine the extent of patient and physician knowledge of appropriate antibiotic prescribing and to seek evidence for a link between antibiotic prescribing and patient satisfaction. Physician perception of patients' expectations regarding antibiotic use is also discussed.
CONCLUSIONS: Both patients and physicians demonstrate poor knowledge regarding appropriate antibiotic prescribing for respiratory infections. Physicians are unable to judge patients' expectations accurately. Educational efforts aimed at both physicians and patients hold the most promise in decreasing unnecessary antibiotic use. These efforts include informing physicians that patient satisfaction is generally linked much more to communication than to the writing of a prescription.