eHealth Treatment Recommendations for the Common Cold across 13 European Countries: Correlation with Antibiotic Use

Background: Antibiotic consumption (ABC) often ensues from patients misbelief that ABs are needed to treat the common cold. To test the impact of eHealth communication, the treatment recommendations on eHealth portals for patients/consumers were explored, modelled and correlated with ABC. Methods: Cross-sectional study: identification of eHealth Common Colds pages (13 European countries); qualitative review of the treatment recommendations for antibiotics, nasal saline drops/irrigation, decongestants, other medicines; conversion to scores and correlation with ABC (ECDC community sector 2022). Traditional use of saline was taken into account as co-variable. Results: e-sites generally explained why ABs are not needed, yet this message and position, as well as treatment e recommendations highly differed. ABC differed by major treatment e-recommendations (p = .017), while a strong negative correlation was found between ABC and the treatment recommendation scores, indicating that ABC was lowest, if the eHealth site recommended saline first-line, while ABC increased if rather decongestants (no saline) were proposed, and even more, if emphasis on various medicines and complications (Spearman rs = -.945, p < .001). Conclusions: The strong inverse correlation of ABC with SNI/treatment recommendations suggests that eHealth recommendations for the common cold may significantly affect ABC, and thus the patients need for ABs. The findings are in line with independent observations that the messages on prudent use of ABs need empowerment by offering patients effective symptom control. eHealth messages and solutions proposed need urgent further study as to change patients expectations and reduce ABC.