Researchers have actually identified seven factors that can help doctors cut unnecessary use of antibiotics in kids with respiratory tract infection and cough.
A new decision-making tool can help reduce unnecessary use of antibiotics in children and prevent them from the potential side effects attributed to the overuse or misuse of these powerful drugs.
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Doctors often recommend antibiotics for children with respiratory tract infections and cough. But up to one-third of prescriptions are unnecessary or treatable with less powerful medications. If the use of antibiotics is decreased in at least these cases, it may contribute to overall reduction in unnecessary antibiotic usage in children.
After examining more than 8000 children, investigators have identified seven key factors that could help doctors determine whether a child with respiratory tract infections and cough requires antibiotic and these seven factors are: short illness (less than 3 days), temperature higher than 100 degrees, age less than 24 months, respiratory distress, wheeze, asthma, and severe vomiting within the last 24 hours. Children with none or just one of these factors do not need to be prescribed antibiotics.
These factors, collectively known as STARWAVe, could be easily detected when a patient visits a doctor and can predict the likelihood of his hospitalization. A child showing four or more characteristics will require hospitalization and no antibiotic or delayed antibiotic may put his life at risk.
“Excessive antibiotic use has contributed to the development of resistance to these drugs,” said lead author Professor Alastair Hay from the University of Bristol, UK.
“The aim of our study was to develop, useable prediction tool based on symptoms and signs to help GPs and nurses identify children presenting in primary care at the lowest and highest risk of future complications and hospitalization, so that antibiotics can be targeted accordingly.”
To test the accuracy of the tool, researchers used 'area under the receiver operating characteristic curve' or AUROC. This graphical plot measures the efficiency of a tool.
An AUROC of 1 represents a perfect test whiles .5 represents a worthless test. The new STARWAVe tool received AUROC of 0.81, which suggests that the tool is accurate enough to determine the severity of a patient’s condition and to predict the need of future hospitalization. However, further researches are needed to confirm the validity of the tool.
“This is the first study of its kind, based on large representative sample of children who visit the doctor with respiratory illness,” said Professor Hay.
“We hope that our proposed clinical tool might eventually enable doctors to quickly and easily identify their lowest and highest risk patients, although more research will be needed to determine just how effective it is in clinical practice. The rule should supplement not replace clinical judgment and doctors and nurses should still advise parents about the symptoms and signs they should look out for and when to seek medical help.”