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Primary care
Broad-spectrum antibiotics gave no clinical benefit and more adverse effects than narrow-spectrum antibiotics in treating acute respiratory tract infections in US children
  1. Morten Lindbaek
  1. Department of General Practice, Antibiotic Centre for Primary Care, Oslo, Norway
  1. Correspondence to Professor Morten Lindbaek, Department of General Practice, Antibiotic Centre for Primary Care, Oslo, 0317, Norway; morten.lindbak{at}

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Commentary on: Gerber JS, Ross RK, Bryan M, et al. Association of Broad- vs Narrow-Spectrum Antibiotics With Treatment Failure, Adverse Events, and Quality of Life in Children With Acute Respiratory Tract Infections. JAMA. 2017 Dec 19;318:2325–2336.


Antimicrobial prescribing is associated with higher levels of resistance; a linear trend by nation has been presented.1 Large variations in antimicrobial prescribing between countries have been demonstrated, the USA is in line with top EU countries like Greece and France, using three times more per inhabitant than the Nordic countries.

Respiratory tract infections (RTIs) in primary care are frequently viral, and a large proportion of bacterial infections such as otitis media, sinusitis and sore throat have little benefit from antibiotic treatment.

Another important focus for avoiding increased antimicrobial resistance is to reduce the proportion of broad-spectrum antibiotics prescribed. Internationally most focus is on cephalosporins, macrolides and quinolones …

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  • Contributors ML has written the commentary.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.