To the Editor.—Dr Gonzales and colleagues1suggest that "[d]etailed studies of patient health-seeking
behavior and physician decision making (relating to disease variables, patient
expectations, and practice characteristics) for colds, [upper respiratory
tract infections], and bronchitis are required to understand what factors
perpetuate the paradox of antibiotic use for conditions they do not help."
However, despite the findings of this article and the authors' conclusion,
it is not necessary to perform detailed studies to understand what factors
perpetuate the misuse of antibiotics. For more than 10 years, numerous articles
in the medical literature have been addressing this subject.2
Even the popular media have taken notice of the issue of excessive use of
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