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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 and the accompanying Editorial by Dr Schwartz and colleagues2 raise important questions about inappropriate use of antibiotics in the treatment of childhood URIs. However, the conclusions about physician specialty and prescription practices must be questioned. On the basis of this study, the Editorial asserts that "family physicians and general practitioners prescribed antibiotics for children . . . more often than did pediatricians." The study actually grouped family physicians together with other physicians, including general practitioners, internists, and other specialists as "nonpediatricians." Obviously all nonpediatricians are not family physicians. Family practice is a distinct medical specialty with its own prescribed training program and board certification. Fewer than half (20% of 48%) of the group compared with the pediatricians were labeled as family physicians. Further, the authors provide no criteria for identifying family physicians and give no numbers of physicians studied. Further analysis, and perhaps more data, would be needed to support these judgments about family physician prescribing patterns.

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