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Respiratory tract infections among children younger than 5 years: current management in Australian general practice
Ruby Biezen1, Allan J Pollack2, Christopher Harrison2
11 Monash University, Melbourne, VIC, Australia. ruby.biezen@monash.edu.
Insights
General practitioners in Australia manage common childhood respiratory infections differently based on the specific illness and GP characteristics. Antibiotic prescribing varied, with male and older GPs more likely to prescribe them for upper respiratory tract infections.
Area of Science:
- Pediatric infectious diseases
- General practice and primary care
- Health services research
Background:
- Common respiratory tract infections (RTIs) are frequent reasons for pediatric consultations in Australian general practice.
- Understanding current management practices is crucial for optimizing treatment and antibiotic stewardship.
- Variations in management may exist based on clinical presentation and practitioner factors.
Purpose of the Study:
- To investigate the contemporary management of four common RTIs in children under five years old by Australian general practitioners (GPs).
- To analyze the association between GP characteristics (sex, age) and management decisions, including antibiotic prescribing.
- To identify patterns in the use of various management strategies for pediatric RTIs.
Main Methods:
- Cross-sectional survey analysis of 4522 GPs from the Bettering the Evaluation and Care of Health (BEACH) program (April 2007–March 2012).
- Focus on consultations involving children younger than 5 years with specific RTIs: acute upper RTI, acute bronchitis/bronchiolitis, acute tonsillitis, and pneumonia.
- Examination of six management options: antibiotics, prescribed non-antibiotics, OTC medications, referrals, pathology, and counselling.
Main Results:
- Of 31,295 encounters, 8157 involved management of one of the four selected RTIs.
- Acute upper RTIs were most common (18.6/100 encounters), followed by bronchitis/bronchiolitis (4.2/100), tonsillitis (2.7/100), and pneumonia (0.6/100).
- Antibiotic prescribing was highest for tonsillitis and lowest for URTI. Male and older GPs prescribed antibiotics for URTI more frequently than female and younger GPs, respectively.
Conclusions:
- GP management of pediatric RTIs in Australia demonstrates variability influenced by the clinical condition and GP demographics (age, sex).
- Further research is needed on parental and professional attitudes towards antibiotics, over-the-counter treatments, and hygiene.
- Understanding these factors can help refine and maintain optimal management strategies for pediatric RTIs.
Objective:
To explore the current management in Australian general practice of common respiratory tract infections (RTIs) in children younger than 5 years.
Design, Setting And Participants:
Analysis of data from a sample of 4522 general practitioners who participated in the Bettering the Evaluation and Care of Health (BEACH) cross-sectional survey, April 2007 to March 2012. Consultations with children younger than 5 years were analysed.
Main Outcome Measures:
GPs' management of four common RTIs (acute upper RTI [URTI], acute bronchitis/bronchiolitis, acute tonsillitis, and pneumonia) in association with six management options: antibiotic medications; prescribed or supplied non-antibiotic medications; medications advised for over-the-counter purchase; referrals; pathology testing; and counselling.
Results:
Of 31 295 encounters recorded, at least one of the four selected paediatric RTIs was managed at 8157 encounters. URTI was managed 18.6 times per 100 GP patient encounters, bronchitis/bronchiolitis 4.2 times, acute tonsillitis 2.7 times, and pneumonia 0.6 times per 100 encounters. Antibiotics were prescribed most frequently for tonsillitis and least frequently for URTI. Male GPs prescribed antibiotics for URTI significantly more often than female GPs, while older GPs prescribed antibiotics for URTI more often than younger GPs.
Conclusion:
GP management of paediatric RTIs in Australia varied according to the clinical problem and with age and sex of the GP. Further research into parents' and health professionals' attitudes and practices regarding the role of antibiotics, over-the-counter medications, and hygiene will help maintain favourable management practices.
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