Best Practices and When Your Doctor Says No
The American College of Physicians and the Centers for Disease Control give guidelines (known as high value care advice) to physicians based on the best current scientific evidence. Physicians try to treat patients based on those guidelines even when patients want a different treatment. Here are three that create the most problems when physicians try to do the right thing.
- (No antibiotics for acute bronchitis) Acute bronchial bronchitis can last up to six weeks with a purulent or dry cough. It is one of the most common out-patient diagnoses we see. More than 15 excellent scientific studies show no benefit in treating with antibiotics and a trend toward adverse complications when antibiotics were used.
- (No antibiotics for pharyngitis unless testing positive for Strept) Only 15% of acute sore throats are caused by bacterial infections. The remainder are viruses that do not respond to antibiotics.
- (No antibiotics for acute rhinosinusitis AKA: Sinusitis) More than 4.3 million adults are diagnosed with sinusitis annually and 80% receive antibiotics despite the fact that it is usually a self limited illness caused by a virus, allergy, or irritant that causes inflammation in the tissue in the nose and sinus cavity. A bacterial cause usually lasts longer than 10 days and is associated with fever.