Lawhorne L W
Department of Family and Community Medicine, University of Missouri-Columbia School of Medicine.
Fam Med. 1991 Feb;23(2):112-6.
A review of the records of patients attending a rural family practice clinic indicated that 13% had received "cold shots" (lincomycin with or without chlorpheniramine). The providers who assumed management of the clinic when the previous physician retired judged these injections inappropriate, but patients believed that they were effective and expected to continue to receive them. This study included 51 consecutive patients seen in the clinic for treatment of a cold and compared those who expected an injection with those who did not. Thirty-four patients (67%) expected an injection but instead received education about upper respiratory tract infections and symptomatic treatment. Half of these patients (17) were not satisfied with this alternative, and 10 reportedly went to another provider for an injection. Compared with patients who did not expect an injection, patients who did were older (P less than .001), had longer duration of symptoms (P less than .02), and were more likely to have tried nonprescription remedies (P less than .001). Analysis of the 1985 National Ambulatory Medical Care Survey indicates that the administration of lincomycin is not uncommon (an estimated 800,000 injections were given in 1985) and that lincomycin is more likely to be administered by a rural solo physician practicing in the north central or southern regions of the United States.
一项针对一家乡村家庭诊所患者记录的回顾显示，13%的患者接受过“感冒针剂”（林可霉素，含或不含氯苯那敏）治疗。在前任医生退休后接管诊所的医护人员认为这些注射并不恰当，但患者们认为它们有效并期望继续接受此类治疗。本研究纳入了连续51名因感冒前来该诊所就诊的患者，并将期望接受注射的患者与不期望接受注射的患者进行了比较。34名患者（67%）期望接受注射，但改为接受了关于上呼吸道感染和对症治疗的教育。这些患者中有一半（17名）对这种替代治疗不满意，据报道有10名患者去了其他医疗机构接受注射。与不期望接受注射的患者相比，期望接受注射的患者年龄更大（P <.001），症状持续时间更长（P <.02），并且更有可能尝试过非处方药物（P <.001）。对1985年全国门诊医疗调查的分析表明，林可霉素的注射使用并不罕见（1985年估计有80万次注射），而且林可霉素更有可能由在美国中北部或南部地区执业的乡村单人执业医生使用。
