Outcomes of antibiotic treatment for respiratory infections in children an observational study in primary care

Abstract

Background

Antibiotic resistance is an increasing global threat, accelerated by both misuse and overuse of antibiotics. Most antibiotics to humans are prescribed in primary care, commonly for respiratory symptoms, and there is a need for research on the usage of and outcomes after antibiotic treatment to counteract antibiotic resistance.

Objective

To evaluate symptom duration, treatment length, and adverse events of antibiotic treatment in children.

Design and Setting

Observational study at four out-of-hours services and one paediatric emergency clinic in Norwegian emergency primary care.

Subjects

266 children aged 0 to 6 years with fever or respiratory symptoms.

Main Outcome Measures

Duration of symptoms and absenteeism from kindergarten/school, treatment length, and reported adverse events.

Results

There were no differences in duration of symptoms, fever or absenteeism when comparing the groups prescribed (30.8%) and not prescribed (69.2%) antibiotics. This lack of difference remained when analysing the subgroup with otitis media.

In the group prescribed antibiotics, 84.5% of parents reported giving antibiotics for 5-7 days, and 50.7% reported no difficulties. Adverse events of antibiotics were reported in 42.3% of the cases, the vast majority being gastrointestinal disturbances.

Conclusion

Children with fever or respiratory symptoms experience similar duration of symptoms and absenteeism regardless of antibiotic treatment. A substantial number of parents reported adverse events when the child received antibiotics. Several parents experienced additional difficulties with the treatment, some ending treatment within day 4.

Trial Registration Number

NCT02496559; Results.

Key Points

• Children with fever or respiratory symptoms treated at OOH services experience similar duration of symptoms or absenteeism, regardless of antibiotic treatment.

• Parents often choose to end antibiotic treatment prematurely due to adverse events, bad taste, or that they find treatment unnecessary.

• Children often experience adverse events when prescribed antibiotics, mainly gastrointestinal symptoms.

Keywords:

• Adverse events
• antibiotic prescribing
• child
• primary care
• respiratory tract infections

Acknowledgements

The authors thank the children, parents, and OOH services at Sotra, Askøy, Nordhordaland, Os and the Paediatric Emergency Clinic at Haukeland University Hospital, who participated in the study.

Ethical approval

The study has been approved by the Regional Committee for Medical and Health Research Ethics (2012/1471/REK Vest).

Disclosure statement

This research received no specific funding.

Additional files

• Questionnaire 1 (in Norwegian): Spørjeskjema til foreldre på legevakt.

• Questionnaire 2 (in Norwegian): Spørjeskjema etter 7 dager.

Data availability statement

The data underlying this article will be shared on reasonable request to the corresponding author.