Background: Although overuse of antibiotics in children has been well documented, few studies have evaluated if the visit time for viral infections varies when antibiotics are or are not prescribed.
Objective: To examine the relationship between physician visit time and antibiotic prescribing for children with viral respiratory tract infection (RTI).
Methods: Data obtained from the National Ambulatory Medical Care Survey (NAMCS) 1993-2003 were surveyed for children < or = 18 years who were seen by a primary care physician and given a primary diagnosis suggestive of viral RTI (cold, upper respiratory infection (URI), bronchiolitis, or brochitis). We excluded visits of children given a comorbid diagnosis justifying antibiotics or a prolonged visit time and those with implausible physician visit times (0 minutes or > 40 minutes). Using univariate and multivariate analysis, we compared self-reported physician visit time when antibiotics were and were not prescribed for viral RTIs.
Results: 2739 visits from the NAMCS database, representing 119,926 visits nationally, met study criteria. Antibiotics were prescribed at 46,949 (39%) visits-75% with a diagnosis of bronchitis, 54% with bronchiolitis, and 30% with cold or URI. After adjusting for factors related to physician visit time, there was no difference in visit duration when antibiotics were or were not prescribed (13.6 +/- 8.4 and 13.3 +/- 9.6 minutes, respectively, P = 0.24).
Conclusion: While antibiotics prescribing for viral RTI in children occurred frequently, our findings do not support the contention that it takes longer 'not to prescribe' antibiotics for children with viral RTIs.