ABSTRACT
ENT is one of the largest components of primary care. Although there is a good evidence base for the more common ailments, it isn't quite as straightforward as it may seem and it is often the fourth-largest cohort of referrals into secondary care. A Cochrane review looked at antibiotics and complications with sore throats and concluded that antibiotics offered a small clinical benefit. They were found to reduce the risk of rheumatic fever by up to 30%, but this would be barely significant in the Western world. The incidence of acute otitis media was reduced by 25%. It is worth offering antibiotics to patients who have been unwell for 48 hours and who fit the Centor criteria. Patient expectations are one of the strongest predictors of antibiotic prescribing decisions. Several meta-analyses have shown that the effectiveness of antibiotics is limited in terms of clinical improvement.
