(HealthDay News) — Doctors are more likely to prescribe unneeded antibiotics as the day progresses, according to a research letter published online in JAMA Internal Medicine.

The researchers analyzed data from 21,867 visits by adults with acute respiratory infections to 23 primary care doctors over 17 months. Antibiotic prescribing increased throughout the morning and afternoon, the study authors observed. The increase corresponded to about 5% more patients receiving antibiotics at the end of a clinic session compared to the beginning.

“Clinic is very demanding and doctors get worn down over the course of their clinic sessions,” study lead author Jeffrey Linder, MD, MPH, of the Brigham and Women’s Hospital’s division of general medicine and primary care, said in a hospital news release. “In our study we accounted for patients, the diagnosis, and even the individual doctor, but still found that doctors were more likely to prescribe antibiotics later in their clinic session,” he said.

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Further research is needed to learn more about why this increase in antibiotic prescribing occurs and to find solutions, the researchers said. “Remedies for this problem might include different schedules, shorter sessions, more breaks or maybe even snacks,” according to Linder.


  1. Linder JA et al. JAMA Intern Med. 2014; doi:10.1001/jamainternmed.2014.5225