***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Objective : To assess the medicalising effect of prescribing antibiotics for sore throat . Setting : 11 general practice s in Engl and . Design : R and omised trial of three approaches to sore throat : a 10 day prescription of antibiotics , no antibiotics , or a delayed prescription if the sore throat had not started to settle after three days . Patients : 716 patients aged 4 and over with sore throat and an abnormal physical sign : 84 % had tonsillitis or pharyngitis . Outcome measures : Number and rate of patients making a first return with sore throat , pharyngitis , or tonsillitis . Early returns ( within two weeks ) and complications ( otitis media , sinusitis , quinsy ) . Outcomes were documented in 675 subjects ( 94 % ) . Results : Mean follow up time was similar ( antibiotic group 1.07 years , other two groups 1.03 years ) . More of those initially prescribed antibiotics initially returned to the surgery with sore throat ( 38 % v 27 % , adjusted hazard ratio for return 1.39 , 95 % confidence interval 1.03 to 1.89 ) . Antibiotics prescribed for sore throat during the previous year had an additional effect ( hazard ratio 1.69 , 1.20 to 2.37 ) . Longer duration of illness ( > 5 days ) was associated with increased return within six weeks ( hazard ratio 2.90 , 1.70 to 4.92 ) . Prior attendance with upper respiratory conditions was also associated with increased reattendance . There was no difference between groups in early return ( 13/238 ( 5.5 % ) v 27/437 ( 6 % ) ) , or complications ( 2/236 ( 0.8 % ) v3/434 ( 0.7 % ) ) . Conclusions : Complications and early return result ing from no or delayed prescribing of antibiotics for sore throat are rare . Both current and previous prescribing for sore throat increase reattendance . To avoid medicalising a self limiting illness doctors should avoid antibiotics or offer a delayed prescription for most patients with sore throat . Key messages Sore throat is one of the commonest presentations of upper respiratory illness in primary care and attendence is increasing Complications are rare with no , or delayed , antibiotic prescription Prescribing antibiotics increases reattendance for future episodes Unless patients are very ill general practitioners should consider exploring concerns , explain the natural history , and avoid or delay prescribing In this double-blind study of 60 infants with undifferentiated respiratory diseases , antibiotics seemed of no benefit in shorten ing the median duration of illness or in preventing secondary complications . The conclusion is drawn that the danger of complications from the antibiotics them selves is greater than the good which many physicians believe that antibiotics produce in such diseases The benefits of antibiotic treatment and a nasopharyngeal culture in children with longst and ing cough were analysed in a prospect i ve r and omized open study . Clinical ly suspected pertussis was excluded . Of 40 children given erythromycin for 7 days , 35 ( 88 % ) recovered in one week , compared with 17/47 ( 36 % ) untreated ( p < 0.0001 ) . Erythromycin  eliminated Moraxella catarrhalis from the nasopharynx in 21/31 children ( 68 % ) , compared with spontaneous disappearance in 7/35 ( 20 % ) untreated controls ( p < 0.001 ) . Purulent bronchitis or otitis media occurred in 2 children ( 5 % ) in the treatment group and in 21 ( 45 % ) in the control group ( p < 0.01 ) . To evaluate the clinical role of isolated pathogens , the 47 untreated subjects were studied . Seven of 35 children harbouring M. catarrhalis recovered , compared with 8/12 in whom this bacterium was absent ( p < 0.01 ) . No correlation was found between the isolation of Haemophilus influenzae or Streptococcus pneumoniae and the clinical outcome .  Children with persistent cough  > 10 days may benefit from erythromycin treatment . M. catarrhalis in the nasopharynx indicates prolonged symptoms and increased risk of bacterial complications The clinical responses of children with upper respiratory infections to 1 of 3 treatment regimens ( tetracycline , penicillin , and placebo ) were evaluated in relation to the bacterial and viral pathogens cultured from nasopharyngeal swabs . The 3 treatment groups were similar in size and in the frequency and type of pathogens recovered . The groups did not differ in their response to the treatment regimens in terms of mean duration of fever , failure to improve , the development of complications , or the persistance of bacterial pathogens in the nasopharynx Abstract The recommended treatment for mild acute respiratory infections ( ARI ) in children is supportive care only , but many physicians , especially in developing countries , continue to prescribe antibiotic treatment because they believe it prevents progression to more severe ARI . To find out whether ampicillin treatment conferred any benefit over supportive care alone , a r and omised , controlled trial was carried out among 889 children ( under 5 years ) with mild ARI in Indonesia . 447 were r and omly allocated  ampicillin ( 25 - 30 mg/kg body weight three times daily for 5 days ) plus supportive care ( continued breastfeeding , clearing of the nose , and paracetamol to control fever ) ; 442 were allocated supportive care only . The treatment groups were almost identical after r and omisation in terms of age , sex , level of parental education , history of measles immunisation , and fever . After 1 week the percentages cured were nearly identical ( 204 [ 46 % ] ampicillin ; 209 [ 47 % ] control ) , as were the percentages of cases progressing to moderate ARI ( 56 [ 13 % ] vs 53 [ 12 % ] ) . The effect of treatment was not modified by age , sex , measles immunisation status , or the educational level of the parents . At the 2-week follow-up , the percentages cured were 62 % ( 277 ) in the ampicillin group and 58 % ( 256 ) in the control group ; 14 % of both groups had progressed to moderate ARI ; and 24 % ( 107 ) and 28 % ( 123 ) , respectively , still had mild ARI . None of the differences in outcome between the ampicillin and control groups was statistically significant . Thus , ampicillin plus supportive care offers no benefit over supportive care alone for treatment of mild ARI in young Indonesian children One hundred forty-two children with purulent nasopharyngitis were r and omized to four treatment groups with an antibiotic ( cephalexin ) alone or combined with a decongestant/ antihistamine ( pseudoephedrine/triprolidine ) or their corresponding placebo equivalents . Follow-up evaluations by parents and physicians and bacteriologic evaluations were performed after 5 to 6 days of therapy . Groups were comparable with regard to age , sex , race , number of patients withdrawn from the study ,  fever greater than 38.0 dec ,  appearance of nasal discharge , nasal crusting and number of days until follow-up . Initial cultures from patients grew : Streptococcus pneumoniae , 46 % ; Haemophilus influenzae type b , 21 % ; and Streptococcus pyogenes , 8 % . Nasal crusting was significantly associated with the growth of S. pneumoniae or H. influenzae type b. There were no significant differences between active drug and placebo treatment groups for change in nasal discharge , complications or apparent drug benefit .  Cephalexin therapy did not result in a decrease in cultivation of pathogenic organisms from the nasopharynx . Significantly more side effects were attributed to pseudoephedrine/triprolidine treatment than to placebo . Routine culture or treatment of purulent nasopharyngitis should not be considered unless future controlled clinical trials demonstrate some therapeutic benefit 52 children with severe cough persisting for more than 10 days were r and omized to treatment with amoxycillin/clavulanic acid or placebo in a prospect i ve double-blinded study . Clinical ly suspected cases of pertussis were excluded , yet 12 ( 23 % ) of the children had laboratory verified pertussis infection . The nasopharyngeal colonization showed a predominance of Moraxella catarrhalis which was isolated in 37 ( 71 % ) children . Streptococcus pneumoniae and Haemophilus influenzae were isolated in 11 ( 20 % ) and 16 ( 30 % ) children , respectively . The antibiotic-treated group had a significantly better recovery in both the pediatrician 's estimation ( p = 0.02 ) and the independent parental judgement ( p = 0.002 ) . These findings are consistent with the view that Moraxella catarrhalis could be directly involved in the pathogenesis of persistent cough in children 
    Output:
    
In view of the lack of efficacy and low complication rates , antibiotic treatment of children with URTI is not supported by current evidence from r and omised trials .