Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Clinical predictors of antibiotic prescribing for acutely ill children in primary care: an observational study

O'Brien, Kathryn, Bellis, Thomas Wyn, Kelson, Mark, Hood, Kerenza, Butler, Christopher and Edwards, Adrian 2015. Clinical predictors of antibiotic prescribing for acutely ill children in primary care: an observational study. British Journal of General Practice (BJGP) 65 (638) , e585-e592. 10.3399/bjgp15X686497

[img]
Preview
PDF - Accepted Post-Print Version
Download (742kB) | Preview

Abstract

Background: Antibiotic overuse and inappropriate prescribing drive antibiotic resistance. Children account for a high proportion of antibiotics prescribed in primary care. Aim: To determine the predictors of antibiotic prescription in young children presenting to UK general practices with acute illness. Design and setting: Prospective observational study in general practices in Wales. Method: A total of 999 children were recruited from 13 practices between March 2008 and July 2010. Multilevel, multivariable logistic regression analysis was performed to determine predictors of antibiotic prescribing. Results: Oral antibiotics were prescribed to 261 children (26.1%). Respiratory infections were responsible for 77.4% of antibiotic prescriptions. The multivariable model included 719 children. Children were more likely to be prescribed antibiotics if they were older (odds ratio [OR] 1.3; 95% confidence intervals [CI] = 1.1 to 1.7); presented with poor sleep (OR 2.7; 95% CI = 1.5 to 5.0); had abnormal ear (OR 6.5; 95% CI = 2.5 to 17.2), throat (OR 2.2; 95% CI = 1.1 to 4.5) or chest examination (OR 13.6; 95% CI = 5.8 to 32.2); were diagnosed with lower respiratory tract infection (OR 9.5; 95% CI = 3.7 to 25.5), tonsillitis/sore throat (OR 119.3; 95% CI = 28.2 to 504.6), ear infection (OR 26.5; 95% CI = 7.4 to 95.7) or urinary tract infection (OR 12.7; 95% CI = 4.4 to 36.5); or if the responsible clinician perceived the child to be moderately to severely unwell (OR 4.0; 95% CI = 1.4 to 11.4). The area under the receiver operating characteristic curve was 0.9371. Conclusion: Respiratory infections were responsible for 74.4% of antibiotic prescriptions. Diagnoses of tonsillitis, sore throat, or ear infection were associated most with antibiotic prescribing. Diagnosis seemed to be more important than abnormal examination findings in predicting antibiotic prescribing, although these were correlated.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > R Medicine (General)
Publisher: Royal College of General Practitioners
ISSN: 0960-1643
Date of First Compliant Deposit: 20 November 2017
Date of Acceptance: 12 May 2015
Last Modified: 29 Jun 2019 01:54
URI: http://orca.cf.ac.uk/id/eprint/79165

Citation Data

Cited 6 times in Google Scholar. View in Google Scholar

Cited 10 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item Edit Item

Downloads

Downloads per month over past year

View more statistics