Name of the Procedure:

Antibiotic neither prescribed nor dispensed (URI, PHAR), (A-BRONCH)

Summary

This procedure involves a clinical decision not to prescribe or dispense antibiotics for conditions such as upper respiratory infections (URI), pharyngitis (PHAR), or acute bronchitis (A-BRONCH). Instead, alternative treatments and symptomatic care are utilized.

Purpose

The primary aim is to address and manage symptoms of URI, pharyngitis, and acute bronchitis without the use of antibiotics, thereby reducing the risk of antibiotic resistance and unnecessary medication use. Patients are instead offered supportive care and education on managing their symptoms.

Indications

• Symptoms of upper respiratory infections such as a runny nose, cough, and sore throat.
• Signs of pharyngitis, including throat pain and redness without evidence of bacterial infection.
• Acute bronchitis presenting with coughing and mucus production, often following a cold or flu.

Preparation

• Patients may undergo diagnostic tests such as throat cultures or strep tests to rule out bacterial infections.
• Physicians will conduct a thorough medical history and physical examination to ensure antibiotics are not warranted.

Procedure Description

1. Clinical Evaluation: The healthcare provider evaluates the patient’s symptoms and medical history.
2. Diagnostic Tests: If necessary, tests are conducted to confirm a viral infection and rule out bacteria.
3. Patient Education: The patient is educated on the viral nature of their illness and the ineffectiveness of antibiotics for viral infections.
4. Symptomatic Treatment: Recommendations include rest, increased fluid intake, and over-the-counter medications such as decongestants or pain relievers.
5. Follow-Up: Advisements on when to seek further medical care if symptoms persist or worsen.

Tools, Equipment, or Technology Used

• Diagnostic tests (e.g., throat cultures, rapid strep tests)
• Educational materials on symptomatic relief and infection prevention

Anesthesia or Sedation

Not applicable.

Duration

The entire process generally takes 15-30 minutes during a routine clinic visit.

Setting

Outpatient clinic or primary care physician’s office.

Personnel

• Primary care physician or healthcare provider
• Nurse or medical assistant for initial assessments and testing

Risks and Complications

• Potential for misdiagnosis if bacterial infection is not correctly identified, though diagnostic tests help mitigate this risk.
• Risk of patient dissatisfaction due to lack of antibiotic prescription, managed through comprehensive education and communication.

Benefits

• Avoidance of unnecessary antibiotic use
• Reduced risk of antibiotic resistance
• Symptom relief through appropriate non-antibiotic treatments
• Empowerment of patients with knowledge about their condition and its management

Recovery

• Patients are advised on self-care measures and the typical duration of their symptoms.
• Expected recovery time varies but often ranges from a few days to a couple of weeks.
• Follow-up appointments scheduled if symptoms do not improve or if complications arise.

Alternatives

If symptoms suggest a bacterial infection:

• Appropriate antibiotic treatment
• Further diagnostic tests or specialist referrals if condition is severe or unresponsive to initial treatment

Patient Experience

• Patients may experience relief from being accurately informed about their illness.
• Communication and education help align patient expectations with the natural course of viral infections.
• Pain and symptom management include over-the-counter medications, making the experience as comfortable as possible.