Discussions About Antibiotics During Adolescent Asthma Visits: Implications for Providers

• Published in: Clinical pediatrics 2019-05, Vol.58 (5), p.564-570
• Main Authors: Willis, Zachary, Carpenter, Delesha Miller, Sayner, Robyn, Sleath, Betsy L.
• Format: Article
• Language: English
• Subjects: Adolescent; Anti-Bacterial Agents - therapeutic use; Antibiotics; Asthma; Asthma - drug therapy; Child; Children; Data processing; Directive Counseling - statistics & numerical data; Female; Follow-Up Studies; Humans; Inappropriate Prescribing - statistics & numerical data; Male; Observer Variation; Patient Education as Topic - statistics & numerical data; Pediatrics; Physician-Patient Relations; Practice Patterns, Physicians' - statistics & numerical data; Primary Health Care; Professional-Family Relations; Schedules; Teenagers
• ISSN: 0009-9228; 1938-2707
• DOI: 10.1177/0009922819829033

Children with asthma are exposed to antibiotics more frequently than their peers. The quality of provider-patient discussion about antibiotics is unknown. In this secondary data analysis, we reviewed existing transcripts of audiotaped adolescent asthma visits using a standardized coding sheet to analyze the quality of communication about antibiotics. Of 539 transcripts, we identified 12 discussions about antibiotics. No patient or parent requested antibiotics. In most cases, discussion was limited to assessment of drug allergies and preferred formulation. In 5 cases (42%), the prescribed antibiotic was not named. We propose a set of communication elements that should be included whenever antibiotics are prescribed, classified into (a) Essential, such as the drug name and dosing schedule; (b) Encouraged, such as expected response to therapy; or (c) Situational, such as discussion of alternatives to antibiotics. Future research should further explore the quality of antibiotic-related conversations among different groups of providers and patients.