Interventions in health care professionals to improve treatment in children with upper respiratory tract infections

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

“…19,20,23 Comparison with existing literature Previous reviews have explored the effectiveness of interventions to change antibiotic prescribing behaviour of clinicians for various types of infection in adults and children. 13,[33][34][35] These reviews and prior research similarly concluded that the most effective interventions involve clinicians and patients, [35][36][37] as well as the general public. 7,32 In a systematic review of antimicrobial control programmes in paediatric outpatient and hospital settings (of which four studies overlap with this review) Patel et al concluded that provider-targeted interventions which featured diagnosis-specific education were more likely to change prescribing for childhood infections.…”

“…10 However, strategies are also needed to help clinicians determine which children are most in need of antibiotics, 11 and reduce inappropriate antibiotic prescribing. 12,13 Given the importance of the parent-clinician interaction in guiding antibiotic use, this study aimed to systematically review the effectiveness of educational or behavioural interventions directed to parents, clinicians, or both, to reduce antibiotic prescribing for children with RTIs in primary care. …”

“…Finally, a systematic review 13 of interventions to change health professional's behaviour (including prescribing, referral, clinician knowledge, and guideline compliance) in management of children with upper RTIs in any type of setting identified 10 studies (six of which are also included in this review 20,[23][24][25]27,28 ). It concluded that computer interventions, educational sessions, collaboratively developed guidelines and training videos were effective in changing practice, and that multifaceted and computer interventions worked best.…”

Shared decision making in primary care: barriers and facilitators of shared decision making in the context of decreasing the use of unnecessary antibiotics for preschool children ages 3-5 with upper respiratory tract infections

“…When antibiotics are indicated, antimicrobial stewardship promotes a targeted approach to antibiotic use such as using specific antibiotics for specific bacteria, rather than broad-spectrum antibiotics. Antimicrobial stewardship requires a multifaceted approach including education of primary care providers (PCPs) and the public on the risks of antibiotic overuse (Boonacker et al, 2010;Maor et al, 2010).…”

“…Within the preschool population, unnecessary antibiotics are most commonly prescribed for viral upper respiratory infections (URIs) (Clavenna & Bonati, 2011;Kutty, 2011). Upper respiratory tract infections (URIs) include viral rhinitis (the common cold), influenza type A and B, acute viral rhinosinusitis, non-streptococcal tonsillitis, and pharyngitis (Boonacker et al, 2010;Rouusounides et al, 2011), and account for the highest number of emergency visits and the second highest number of primary care and outpatient visits in children (Touchie, 2013). Approximately 50% of total antibiotic prescriptions for preschool children are unnecessary, with 20% being attributed to URIs (Clavenna & Bonati, 2011;Maor et al, 2011).…”