Decision-making tool may help doctors cut unnecessary antibiotic prescribing

ScienceDaily | Published online: 1 September 2016

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Respiratory tract infections (RTI) with cough are the most common reason children are prescribed antibiotics by their doctors, but up to a third of prescriptions may be unnecessary. A new study of over 8000 children has identified seven key predictors which could help general practitioners (GPs) and nurses in primary care identify low risk children who are less likely to need antibiotics, according to new research published in The Lancet Respiratory Medicine.

The authors estimate that if antibiotic prescribing in this low risk group was halved, and even if it increased to 90% in high risk patients, the new tool could reduce antibiotic prescribing to children with RTI and coughs by 10% overall, similar to other interventions used to combat antibiotic resistance.

The proposed tool called STARWAVe uses seven predictors of future hospitalization that can be easily identified by doctors and nurses during a patient visit — short illness (less than 3 days), high temperature (?37.8°C on examination or parent reported severe fever in the previous 24 hours), aged under 2 years, respiratory distress, wheeze, asthma, and moderate/severe vomiting in the previous 24 hours. Children presenting with no more than one of these items are deemed at very low risk of future complications. The authors say that the rule now needs externally validating in a randomised trial, but could be a useful tool to improve the targeting of antibiotics to reduce the growing threat of antibiotic resistance.

View the original research articles here and here.

Read the full commentary here

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