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Antibiotic prescribing for upper respiratory tract infections in children: how can we improve?

Graham Easton1, Sonia Saxena2

  • 1General Practitioner, Ealing PCT, London, UK and Senior Clinical Teaching Fellow, Department of Primary Care and Public Health, Imperial College London, UK.

London Journal of Primary Care
|May 8, 2015
PubMed

Insights

Antibiotic prescribing for pediatric upper respiratory tract infections (URTIs) is increasing despite limited benefits. This article examines reasons for this trend and offers practical solutions for general practitioners (GPs) to implement guideline recommendations.

Area of Science:

  • Pediatrics
  • General Practice
  • Infectious Diseases

Background:

  • Upper respiratory tract infections (URTIs) are highly prevalent in pediatric populations.
  • Antibiotic use for uncomplicated URTIs in children is often inappropriate, as complications are rare and antibiotics provide minimal benefit.
  • Recent trends show an increase in antibiotic prescribing for pediatric URTIs, reversing a previous decline.

Purpose of the Study:

  • To explore the reasons behind the recent increase in antibiotic prescribing for pediatric URTIs.
  • To evaluate the evidence for withholding antibiotics in uncomplicated URTIs.
  • To guide general practitioners (GPs) in interpreting and applying National Institute for Health and Clinical Excellence (NICE) guidelines for pediatric URTI management.

Main Methods:

  • Review of current literature on URTI treatment and antibiotic stewardship in children.
  • Analysis of prescribing trends and influencing factors.
  • Exploration of strategies for guideline implementation in primary care settings.

Main Results:

  • Identified factors contributing to increased antibiotic prescribing, including diagnostic uncertainty and patient expectations.
  • Highlighted the limited efficacy of antibiotics in uncomplicated pediatric URTIs.
  • Discussed challenges faced by GPs in adhering to antibiotic prescribing guidelines.

Conclusions:

  • Emphasized the need for improved understanding and implementation of evidence-based guidelines for pediatric URTI management.
  • Suggested practical approaches to support GPs in reducing unnecessary antibiotic prescriptions.
  • Advocated for strategies to align clinical practice with NICE recommendations for URTI in children.

Keywords:
antibioticschildrenguidelinesprescribingupper respiratory tract infection

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