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Delayed Antibiotic Prescription for Children With Respiratory Infections: A Randomized Trial

Gemma Mas-Dalmau1,2, Carmen Villanueva López3, Pedro Gorrotxategi Gorrotxategi4

  • 1Iberoamerican Cochrane Center, and.

Pediatrics
|February 12, 2021
PubMed

Insights

Delayed antibiotic prescription (DAP) is as effective as immediate (IAP) or no antibiotic prescription (NAP) for children's respiratory infections. DAP significantly reduces antibiotic use and gastrointestinal side effects.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Primary Care

Background:

  • Uncomplicated respiratory infections are common in children.
  • Antibiotic overuse contributes to antimicrobial resistance.
  • Optimal antibiotic prescribing strategies are needed.

Purpose of the Study:

  • To compare the effectiveness and safety of delayed antibiotic prescription (DAP) versus immediate antibiotic prescription (IAP) and no antibiotic prescription (NAP).
  • To evaluate outcomes in children with acute uncomplicated respiratory infections.

Main Methods:

  • A randomized clinical trial involving 436 children across 39 primary care centers.
  • Children were assigned to DAP, IAP, or NAP groups.
  • Primary outcomes included symptom duration and severity; secondary outcomes assessed antibiotic use, satisfaction, and complications.

Main Results:

  • No significant differences in symptom duration or severity were observed among the three strategies.
  • Antibiotic use was significantly lower in the DAP and NAP groups compared to IAP.
  • Gastrointestinal adverse effects were more frequent with IAP.

Conclusions:

  • Delayed antibiotic prescription is a safe and effective strategy for uncomplicated pediatric respiratory infections.
  • DAP reduces unnecessary antibiotic exposure and associated adverse effects.
  • This approach supports antimicrobial stewardship in primary care.
Abstract

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