New screening tool could be used by physicians to curb unnecessary prescribing of antibiotics.
A new research study involving over 8,000 children in England has identified seven factors that physicians can use to determine if children with acute respiratory infections are likely to be admitted to the hospital, and the research team says doctors could use these factors to lower the use of prescribed antibiotics.
Respiratory tract infections (RTIs) are among the most common reasons that physicians prescribe antibiotics around the world, and in some cases, the drugs are prescribed just to make the child’s parents feel better, even if the illness isn’t actually severe.
The seven factors are: short Illness (less than three days), temperature of higher than 100 degrees, children under the age of two, signs of respiratory distress, wheezing, asthma and vomiting. The children received a score of one point for each of the seven factors after the examination, and the scores determined the risk of hospitalization.
According to the research, children with none or one of these factors would be considered low risk for hospitalization. Those children presenting with two or three of the factors would be considered normal risk, and children with four or more would be at a high risk for being admitted to the hospital within the next 30 days.
The study included 8,394 children, between the ages of three months and 16 years old, that were treated at almost 250 general practitioners during the period from 2011 through 2013. These children all had an acute cough that had persisted for less than four weeks and an RTI. The physicians recorded the results of their examinations, as well as symptoms reported by the parents and other demographic information.
From the observed group, only 78 were actually admitted to the hospital within the 30-day period following the examination.
The study authors say they recommend a strategy of no antibiotics for those children in the low-risk category, followed by a no antibiotic or delayed use of antibiotics for the normal-risk, and finally close monitoring for those in the high-risk group for the next 24 hours, looking for signs of deterioration in their health.
The team say they estimate that cutting the prescribing of antibiotics for the low-risk group in half, maintaining the same level for the normal scores, and prescribing at 90 percent for the high-risk children would cut overall antibiotic prescribing by 10 percent across the globe.
The authors, whose work was published in The Lancet Respiratory Medicine, say more research is needed due to the limitations of the small number of actual hospital admissions in their research.