Immediate Antibiotic Prescriptions for Children’s Coughs ‘unnecessary’ Bristol Study Finds

Taking a child to the doctor with a cough and leaving with antibiotics does not reduce the chances of hospitalisation.

Researchers from the Universities of Bristol, Southampton, Oxford and Kings College London found ‘little’ evidence to show that children prescribed antibiotics for a cough or respiratory infection would avoid return visits, worsening symptoms or hospital admissions.

The study published in the British Journal of General Practice said that this is an area of ‘unnecessary’ antibiotic prescribing that could be ‘reduced’.

From the Centre for Academic Primary Care at the University of Bristol and NIHR CLAHRC West, and lead author of the study, Dr Niamh Redmond said: “The good news is that most children who present to their GP with acute cough and respiratory infection symptoms are at low risk of hospitalisation. We know that GPs, for a variety of reasons, commonly prescribe antibiotics in these cases as a precautionary measure. However, our study shows that antibiotics are unlikely to reduce this already small risk. This means that along with other strategies, there is real potential to reduce unnecessary antibiotic prescribing, which is a major contributor to the growing public health threat of antimicrobial resistance.”

She also said that delaying a prescription for a child with a bad cough many be ‘preferable’ because it shows that by doing so reduces the need to return.

Delayed antibiotic prescribing is giving parents or carers a prescription to wait and see if symptoms got worse before using it.

The research team was funded by the National Institute for Health Research. They analysed data from a study of 8,320 children aged between 3 months and 15 years who had seen their GP with a cough or respiratory infection. They specifically looked to see what adverse outcomes had happened within 30 days of attending the appointment.

Immediate antibiotics were prescribed to 28 per cent of the children and delayed antibiotics to nine per cent.

Data showed that of all children, just 0.8 per cent – 65 children – ended up in hospital and 4 per cent – 350 children – had to return to the GP because their symptoms got worse.

The data showed that there was no evidence that giving antibiotics lowered the risk of hospitalisation, though there was evidence to show that delayed prescribing did.

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