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To the Editor: In his Editorial, Dr Ebell¹ discusses his opinion that antibiotics are overprescribed for acute lower respiratory tract infection. While I agree with this general opinion, I dispute his specific conclusion that the findings in the study by Little et al² show little difference in the percentage of patients satisfied among those who received an immediate antibiotic (86%), a delayed antibiotic (77%), and no antibiotic (72%).

These differences may appear small to an academic physician and may not be important to physicians practicing in a single payer system as in England. But to a physician group that is being evaluated by multiple medical insurance plans according to patient satisfaction in the competitive US market, these differences are large and may distinguish keeping and losing a contract. I suspect that you would have the prompt attention of a hospital or medical group manager if you said that the physicians . . . [Full Text of this Article]

J. Stephan Stapczynski, Jr, MD
steve_stapczynski@medprodoctors.com
Emergency Medicine Department
Maricopa Medical Center
Phoenix, Ariz

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