This study confirms assumptions that large
quantities of symptomatic and, in smaller
quantities, antimicrobial medications, are
used by patients with LRTI presenting
in primary care, and that remarkable
differences exist between countries. This
use of medication must be balanced
against costs, side effects, and potential
underdiagnosis of relevant diseases like
COPD, asthma, and allergies. Many of
these medications are probably not helpful
and robust evidence is not available for
most of the medications used. On the other
hand, self-medication might be beneficial,
as there is evidence that patients who
consult the pharmacy first have lower GP
attendance rates.27Also, in this study, a
high prevalence of asthma and/or COPD
was found in patients who used inhaled
bronchodilators as self-medication before
consultation. This on-demand use might
very well be in line with advised asthma
and/or COPD action plans on medication
use in case of an exacerbation, which are