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New decision-making tool could cut unnecessary antibiotics prescribing

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2 September 2016

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Researchers have developed a tool to help health workers detect which children are most likely to be hospitalised from respiratory tract infections (RTIs).

In a study published in Lancet Respiratory Medicine, researchers designed the tool in an effort to cut down on unnecessary antibiotic prescribing.

The tool, which is said to be able to reduce antibiotics prescribing by 10%, found seven characteristics that GPs could use to identify children at risk of hospitalisation.

These include short (≤3 days) illness; high temperature; age (<24 months); recession; wheeze; asthma; and vomiting.

Researchers noted that the risk of hospitalisation increases with the number of characteristics present.

They recommended that GPs prescribe no antibiotics or delayed treatment for those with three or fewer characteristics – considered low or normal risk.

Primary care practitioners such as GPs are responsible for 80% of all antibiotic prescriptions in the UK.

Around half of these are for RTIs, despite the fact that their effectiveness in treating RTIs has been shown to be limited.

Dr Maureen Baker, chair of the Royal College of General Practitioners (RCGP), said the tool would be “highly valuable”.

She said: “When prescribed appropriately antibiotics can be life-saving drugs, but they aren’t always the best course of treatment for minor conditions – including respiratory tract infections, which often don’t require antibiotics – and we need to work together to make the public realise this, in the best interests of their health and the worldwide population.

“Such a tool would also be very useful for GPs when explaining to patients, and their families, that antibiotics are not always the best course of treatment, as we often come under huge pressure to prescribe these drugs.

However, she added that the test “is not going to become widely available overnight” and GPs need to make the public aware that “antibiotics are not always the answer” in the meantime.

She said: “It is particularly vital that we protect the safety of our young patients by ensuring that they don’t start building up a resistance to antibiotics early on in their life, so that antibiotics remain effective in the future when they might really need them.”