Delayed prescriptions have been shown to lower antibiotic use for upper respiratory tract infections (which are mostly viral).

This trial will test the hypothesis that if the clinician post-dates the delayed prescription by 2 days, rather than dating it on the day the patient is seen, there will be a further drop in the rate of antibiotic use.

6 family doctors and 2 nurse practitioners in a small rural town will issue delayed antibiotic prescriptions to adult patients with new acute respiratory tract infections. The delayed prescriptions will be randomly dated for either the day of the office visit, or 2 days later. The 2 local pharmacies will note whether the prescription is cashed, and when.

It is hypothesised that post-dating the prescription will result in a reduced cashing rate.

Each arm of the study (Usual v Post-Dated) will contain 75 subjects. This sample will have the power to detect a 25% change in prescription use.

Inclusion Criteria:

• Adults aged 18 years or older
• Adults with an untreated upper respiratory tract infection
• Adults presenting for the first time to a family physician or a nurse practitioner

Exclusion Criteria:

• Less that 18 years
• Having a clear indication for antibiotic therapy

This was an ad hoc study, and therefore no baseline information was recorded for this study design

This study did not involve reporting of adverse reactions over the 19 days time span

This study was educational in nature. It was designed to just determine the timing of the number of the prescriptions filled by individuals. It is did not involve the gathering of any information on adverse effects.