Doctors’ Decision-Making Tool Could Cut Unnecessary Antibiotic Use

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A new decision-making tool for doctors may help reduce unnecessary use of antibiotics in children with respiratory tract infections and cough, researchers report.

Respiratory tract infections with cough are the most common reason children are prescribed antibiotics. But as many as one-third of those prescriptions may be unnecessary, the study authors said.

Using information from more than 8,000 children, the investigators identified seven key predictors that could be used to help determine whether a child with a respiratory tract infection and cough is likely to require antibiotics.

Those predictors are: short illness (less than three days); fever of 100 F or higher; younger than 2 years old; respiratory distress; wheeze; asthma; and moderate/severe vomiting in the previous 24 hours.

Children with none, or just one, of these predictors are at very low risk of future complications, the researchers said.

If antibiotic use in low-risk children was halved — and even if it increased 90 percent in high-risk children during the same time — this decision-making tool could reduce antibiotic use among children with respiratory infection and cough by 10 percent, the findings suggested.

Further research is needed to confirm the validity of the tool, the study authors added.

The findings were published Sept. 1 in The Lancet Respiratory Medicine.

“Excessive antibiotic use has contributed to the development of resistance to these drugs,” lead author Alastair Hay, a professor at the University of Bristol in England, said in a journal news release.

“The aim of our study was to develop a simple, usable prediction tool based on symptoms and signs to help [doctors] and nurses identify children presenting in primary care at the lowest and highest risk of future complications and hospitalization, so that antibiotics can be targeted accordingly,” Hay explained.

More information

The American Academy of Pediatrics has more on antibiotics.

Source: HealthDay

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