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Authors make no comment on the cause for such significant differences and propose that future studies should study this issue; however, they make clear that this is not based on any “biological” foundation because African-American children suffer the same, or even higher, rate of acute otitis media and other infections than caucasian children; in this study, we found that antibiotics were prescribed 25% less often to African-American pediatric patients. Moreover, a recent study showed a disproportionately higher incidence of methicillin-resistant Staphylococcus aureus infections among African-American children.2 Authors estimate that the higher rate of antibiotic prescriptions among caucasian patients accounts for an overtreatment of the caucasian population rather than an undertreatment of the African-American population. S e v e r a l s t u d i e s 3 , 4 d e m o n s t r a t e d t h a t doctors’ indications are influenced by parental expectations, and that it is most likely for a child to receive an indication for antibiotics and a diagnosis that warrants such treatment if parents request or expect it. These studies have also shown that parents of African-American children tend to be less demanding than parents of caucasian children and this may serve, at least partially, as an explanation for this study’s results. Some studies also reported that4doctors believe that the African-American population will show a lower level of treatment compliance, and therefore end up issuing fewer antibiotic prescriptions compared to the caucasian population. The fact that such difference in the diagnosis of common infectious diseases such as acute otitis media and pharyngitis does not occur in urinary tract infections, which are diagnosed based on more objective data, or in pneumonia, which could have serious consequences if undiagnosed, proves that doctors have an implicit subjective attitude in the management of upper respiratory tract infections. An outcome measure that was not included in this study was researchers’ ethnic or “racial” origin given that other studies have demonstrated different attitudes according to whether the doctor has the same “race” as his/her patient.4 How the concept of race influences medical practice. A reflection based on a study about the diagnosis and treatment of upper respiratory tract infections in American children

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How the concept of race influences medical practice. A reflection based on a study about the diagnosis and treatment of upper respiratory tract infections in American children.