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October 28, 1998

Antibiotics for Children With Upper Respiratory Tract Infections

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(16):1399-1402. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-16-jbk1028

To the Editor.—The study by Dr Nyquist and colleagues1 found that nonpediatricians more commonly prescribed antibiotics for children than pediatricians, while the accompanying Editorial by Dr Schwartz and colleagues2 questions the skills of family physicians and general practitioners. However, the assertions by Schwartz et al are specious for 2 reasons. First, the assumption that a specialty is to blame overstates the evidence. Nyquist and colleagues found an association, not a causal relationship, between prescription rates and nonpediatricians. Other variables affecting antibiotic use (eg, severity of illness, follow-up arrangements, patient income) that are not included in the model may be distributed unevenly by specialty. Second, the explanations that Nyquist et al offer for what is wrong with family practice have no basis in fact.

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