Non-antibiotic treatment recommendations: delivery formats and implications for parent resistance

Soc Sci Med. 2005 Mar;60(5):949-64. doi: 10.1016/j.socscimed.2004.06.040.


This study draws on a database of 570 community-based acute pediatric encounters in the USA and uses conversation analysis as a methodology to identify two formats physicians use to recommend non-antibiotic treatment in acute pediatric care (using a subset of 309 cases): recommendations for particular treatment (e.g., "I'm gonna give her some cough medicine.") and recommendations against particular treatment (e.g., "She doesn't need any antibiotics."). The findings are that the presentation of a specific affirmative recommendation for treatment is less likely to engender parent resistance to a non-antibiotic treatment recommendation than a recommendation against particular treatment even if the physician later offers a recommendation for particular treatment. It is suggested that physicians who provide a specific positive treatment recommendation followed by a negative recommendation are most likely to attain parent alignment and acceptance when recommending a non-antibiotic treatment for a viral upper respiratory illness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Communication
  • Humans
  • Parents
  • Physician-Patient Relations*
  • Practice Patterns, Physicians'*
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / therapy*


  • Anti-Bacterial Agents