Antibiotics ‘do not cut hospitalisation risk’ in children with respiratory infections

An analysis of children presenting in primary care has found that delaying or withholding antibiotics is the most appropriate way of treating suspected respiratory tract infections.

Child blowing his nose

Antibiotic prescription does not reduce the risk of hospitalisation in children presenting with acute cough and respiratory symptoms in primary care, study results show[1]

Researchers analysed data from a prospective cohort study including 8,320 children aged 3 months to <16 years presenting to primary care with acute cough or a suspected respiratory tract infection. Overall, 28% were given an immediate prescription and 9% were given a delayed prescription.

The rates of hospitalisation or re-consultation for deterioration within 30 days were 0.8% and 4.0%, respectively.

The researchers found that, compared with no antibiotics, there was no evidence that either type of prescription reduced the risk of hospitalisation. However, delayed rather than immediate antibiotic prescriptions were associated with a significantly reduced risk of deterioration and subsequent re-consultation (risk ratio: 0.55 versus 0.82).

The team said the results were in line with previous research in both children and adults that has indicated that where an antibiotic is deemed necessary in primary care, a delayed prescription may be the most appropriate.

“Most children presenting with acute cough and respiratory symptoms in primary care are not at risk of hospitalisation, and antibiotics may not reduce the risk,” they concluded in the British Journal of General Practice (online, 27 September 2018).


[1] Redmond N, Turnbull S, Stuart B et al. Impact of antibiotics for children presenting to general practice with cough on adverse outcomes: secondary analysis from a multicentre prospective cohort study. Br J Gen Pract 2018. doi: 10.3399/bjgp18X698873

Last updated
Clinical Pharmacist, CP, October 2018, Vol 10, No 10;10(10):DOI:10.1211/PJ.2018.20205525

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