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To the Editor.—Dr Nyquist and colleagues¹ and Dr Gonzales and colleagues² have addressed the prescription practices of ambulatory care physicians, including pediatricians,¹ with particular reference to the degree of inappropriate antibiotic use. The authors reexamine the 1992 National Ambulatory Medical Care Survey (NAMCS) to determine how often antibiotics are prescribed for viral illnesses and conclude that overprescribing is widespread and that family practitioners were somewhat more guilty than pediatricians.

The methods used in these studies are suspect for the following reason: The authors state, "Colds, URIs [upper respiratory tract infections], and bronchitis represent a set of infections that have a viral etiology in the vast majority (>90%) of cases, so . . . antibiotics have little or no clinical impact on their resolution."² This statement should be clarified. While it is generally agreed that the common cold is a viral condition, there is no International Classification of Diseases, Ninth . . . [Full Text of this Article]

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