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One possible cause of inappropriate antibiotic prescribing is “decision fatigue,” a decline in the quality of decision-making caused by repeated decision-making demands. Researchers explored the concept by analyzing 21,867 visits (to 23 Boston primary care practices) to address acute respiratory infections (ARIs) for which antibiotics often are prescribed inappropriately. Visits by patients with serious chronic illnesses or comorbid acute illnesses, such as skin infections (for which antibiotics usually are required), were excluded. Using national clinical practice guidelines, visits were coded as “antibiotics sometimes indicated” or “antibiotics never indicated.”
About two thirds of visits were for ARIs for which antibiotics never are indic…