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New tool aims to cut child antibiotic use

Spotting low-risk cases of respiratory tract infection in children could reduce antibiotic use.

A new decision-making tool could help doctors reduce unnecessary antibiotic prescribing for children with coughs and respiratory tract infections (RTIs).

children and antibiotics
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Using 8,000 child records, researchers developed seven predictors to help GPs and nurses in primary care to spot low-risk children that are less likely to need the drugs.

RTIs with coughs are the most common reason children are given antibiotics, with the study in The Lancet Respiratory Medicine calculating a third of prescriptions are unnecessary.

‘Excessive antibiotic use has contributed to the development of resistance to these drugs,’ says lead author Professor Alastair Hay from Bristol University.

‘The aim of our study was to develop a simple, usable prediction tool to help GPs and nurses identify children presenting in primary care at the lowest and highest risk of future complications and hospitalisation.’

Low-risk children

The study estimates if antibiotic prescribing for low-risk children was halved, and even if it increased to 90% in high-risk patients, the new tool could reduce prescribing by 10%.

The tests, acronymed STARWAVe, are Short illness (under 3 days), high Temperature, Age under 2, Respiratory distress, Wheeze, Asthma and moderate or severe Vomiting in past 24 hours. Only one factor? Hold the antibiotics.


Hay AD et al (2016) Development and internal validation of a clinical rule to improve antibiotic use in children presenting to primary care with acute respiratory tract infection and cough: a prognostic cohort study. The Lancet Respiratory Medicine. doi: 10.1016/ S2213-2600(16)30272-7


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