Changes in clinical indications for community antibiotic prescribing for children in the UK from 1996 to 2006: will the new NICE prescribing guidance on upper respiratory tract infections just be ignored?

Thompson, Paula L; Spyridis, Νikos; Gilbert, Ruth; Saxena, Sonia; Long, Paul F.; Johnson, Alan P.; Wong, Ian C. K.

doi:10.1136/adc.2008.147579

Cited by 77 publications

(53 citation statements)

References 28 publications

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“…To some extent these efforts have been successful, leading to reductions in the UK of 24%, from 572 antibiotic prescriptions per 1000 child-years in 1996 to 435 prescriptions per 1000 child-years in 2000. 8 However, US data indicates that while overall antibiotic prescription rates decreased during the 1990s, prescribing rates of broad spectrum antibiotics for children with RTIs actually increased. 9 Prescribing rates for nonspecific RTIs in the UK have increased by 10% since 2002.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reducing antibiotic prescribing for children with respiratory tract infections in primary care: a systematic review

Vodicka¹,

Thompson²,

Lucas³

et al. 2013

Br J Gen Pract

103

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BackgroundRespiratory tract infections (RTIs) in children are common and often result in antibiotic prescription despite their typically self-limiting course. AimTo assess the effectiveness of primary care based interventions to reduce antibiotic prescribing for children with RTIs. Design and settingSystematic review. Method MEDLINE ®, Embase, CINAHL ® , PsycINFO, and the Cochrane library were searched for randomised, cluster randomised, and nonrandomised studies testing educational and/or behavioural interventions to change antibiotic prescribing for children (<18 years) with RTIs. Main outcomes included change in proportion of total antibiotic prescribing or change in 'appropriate' prescribing for RTIs. Narrative analysis of included studies was used to identify components of effective interventions. ResultsOf 6301 references identified through database searching, 17 studies were included. Interventions that combined parent education with clinician behaviour change decreased antibiotic prescribing rates by between 6-21%; structuring the parent-clinician interaction during the consultation may further increase the effectiveness of these interventions. Automatic computerised prescribing prompts increased prescribing appropriateness, while passive information, in the form of waiting room educational materials, yielded no benefit. ConclusionConflicting evidence from the included studies found that interventions directed towards parents and/or clinicians can reduce rates of antibiotic prescribing. The most effective interventions target both parents and clinicians during consultations, provide automatic prescribing prompts, and promote clinician leadership in the intervention design. Keywordsanti-bacterial agents, children, prescriptions, primary health care, respiratory tract infections.e445 British Journal of General Practice, July 2013 (from inception through June 2012) were searched using terms for RTIs, children, parents, education, antibiotic prescription, and consultation (Table 1). One author screened titles and abstracts based on predefined inclusion criteria to identify relevant studies and reviewed reference lists and related citations of selected studies to identify additional references. Two authors reviewed the full-text of selected studies to determine inclusion. Disagreements were settled through discussions with a third author.Controlled studies were included that used a randomised, cluster randomised, non-randomised or one-group pre-and post-test design to assess the effectiveness of educational or behavioural interventions to change clinicians' antibiotic prescribing for acute RTIs in children (birth to 18 years) in primary care settings (family practice, emergency, or paediatric primary care). Outcomes of interest were change in proportion of antibiotic prescriptions issued for RTIs in children, or change in 'appropriate' antibiotic prescribing. Comparisons included no-treatment or alternate treatment controls. Studies were excluded if they were: from in-patient settings; evaluations of...

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Section: Introductionmentioning

confidence: 99%

“…9 Prescribing rates for nonspecific RTIs in the UK have increased by 10% since 2002. 8 This upward trend is concerning in light of evidence-based practice recommendations that propose a 'wait and see' approach for the majority of RTIs.…”

Section: Introductionmentioning

confidence: 99%

Reducing antibiotic prescribing for children with respiratory tract infections in primary care: a systematic review

Vodicka¹,

Thompson²,

Lucas³

et al. 2013

Br J Gen Pract

103

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“…Не было никаких существенных изменений в лечении синусита [15]. Внедрение образовательной программы в Велико-британии в течение 6 лет позволило сократить выписку антибиотиков на 24%: от 572 назначений антибиотиков на 1 000 детей в год в 1996 г. до 435 рецептов на 1 000 детей в год в 2000 г [16]. Авторы делают вывод, что целе-направленные образовательные программы могут улуч-шить практику назначения АМТ для респираторных инфекций у детей и взрослых.…”

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Ways of Optimizing Antimicrobial Therapy for the Treatment of Respiratory Diseases

Бердникова¹,

Цыганко²,

Журавлева³

et al. 2017

Med. sov.

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“…These databases have been recognised and validated as tools to conduct paediatric pharmacoepidemiological research and drug utilisation studies. [2][3][4] Such studies provide population-level data representative of GP paediatric prescribing habits.…”

Section: Introductionmentioning

confidence: 99%

Oral penicillin prescribing for children in the UK: a comparison withBNF for Childrenage-band recommendations

Saxena

Ismael²,

Murray³

et al. 2014

Br J Gen Pract

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Changes in clinical indications for community antibiotic prescribing for children in the UK from 1996 to 2006: will the new NICE prescribing guidance on upper respiratory tract infections just be ignored?

Abstract: Objective: To analyse changes in clinical indications for community antibiotic prescribing for children in the UK between 1996 and 2006 and relate these findings to the new NICE guidelines for the treatment of upper respiratory tract infections in children.

Cited by 77 publications

References 28 publications

Reducing antibiotic prescribing for children with respiratory tract infections in primary care: a systematic review

Reducing antibiotic prescribing for children with respiratory tract infections in primary care: a systematic review

Ways of Optimizing Antimicrobial Therapy for the Treatment of Respiratory Diseases

Oral penicillin prescribing for children in the UK: a comparison withBNF for Childrenage-band recommendations

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