So in order to detect the risk of hospitalization, researchers created the tool that detects children highly likely to hospitalization.
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She said: “When prescribed appropriately antibiotics can be life-saving drugs, but they aren’t always the best course of treatment for minor conditions – including respiratory tract infections, which often don’t require antibiotics – and we need to work together to make the public realise this, in the best interests of their health and the worldwide population”.
The tool uses seven characteristics that Global Positioning System consider before evaluating the risk of hospitalization with antibiotic intake in children.
Led by researchers from the Centre for Academic Primary Care at the University of Bristol, the research team found seven characteristics that can be used to identify children with cough and RTI at very low, normal and high risk of future hospitalisation: short (≤3 days) illness; high temperature; age ( 24 months); recession; wheeze; asthma; and vomiting giving the mnemonic “STARWAVe”. There are few efficacious interventions for respiratory tract infection available to primary care clinicians beyond offering reassurance and self-management advice, so the modest benefit offered by antibiotics can persuade general practitioners to prescribe them. Global Positioning System and nurses find making decisions about prescribing antibiotics in children with RTIs hard.
The study authors say they recommend a strategy of no antibiotics for those children in the low-risk category, followed by a no antibiotic or delayed use of antibiotics for the normal-risk, and finally close monitoring for those in the high-risk group for the next 24 hours, looking for signs of deterioration in their health.
Median age of children in the sample was 3 years, 52% were boys and 78% were white. But they added that it potentially could reduce antibiotic prescriptions, in combination with other tests.
Those predictors are: short illness (less than three days); fever of 100 F or higher; younger than 2 years old; respiratory distress; wheeze; asthma; and moderate/severe vomiting in the previous 24 hours. The new STARWAVe rule gave an AUROC of 0.81, which indicates it should predict the risk of hospitalisation with high accuracy.
The accuracy of the rule was measured by a figure called the “area under the receiver operating characteristic curve”, or AUROC.
National Institute for Health Research (NIHR). The tool also prevents children from developing antibiotic resistance.
These findings were published in The Lancet Respiratory Medicine. These children all had an acute cough that had persisted for less than four weeks and an RTI. Yet, 33% of the low risk group, 44% of the middle risk group and 67% of the high risk group actually received antibiotics.
Doctors are likely to over-prescribe antibiotics for children because it is hard to know if a child is at risk of developing more severe symptoms but a new decision making tool may help doctors prescribe antibiotics to children more efficiently reducing unnecessary use of antibiotics that could lead to antibiotic resistance.
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If antibiotic use in low-risk children was halved – and even if it increased 90 percent in high-risk children during the same time – this decision-making tool could reduce antibiotic use among children with respiratory infection and cough by 10 percent, the findings suggested. Specifically, we postulated that baseline clinical characteristics could be used to distinguish good from poor prognosis in children presenting to primary care with acute respiratory tract infection and cough, and that clinically useful coefficients (for use with computer assistance) and points-based algorithms could be developed.
