Delayed antibiotics probably safe and reduces re-consultation rates

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Goodfellow Gems

Delayed antibiotics probably safe and reduces re-consultation rates

A review1 of individual patients in randomised trials of delayed antibiotics (or back pocket antibiotics) for acute infections. The conditions included common cold, acute otitis media, sore throat, respiratory tract infection and cough.

Compared with immediate antibiotics, delaying does not result in higher complication rates (possibly lower) and does not decrease patient satisfaction. It can be a good strategy to introduce an antibiotic seeking patient to consider not taking immediate antibiotics. The reviewers suggest this may be a way of resolving mismatched expectations between clinicians and patients.  In New Zealand, this is not an option for Māori and Pacific patients with sore throat due to the risk of rheumatic fever.


  1. Delayed antibiotic prescribing for respiratory tract infections: individual patient data meta-analysis BMJ (2021) View here

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.

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