Evidence map›Paper›PMID 17656505›Full record

ArticleBMJ (Clinical research ed.)2007

Effect of antibiotic prescribing on antibiotic resistance in individual children in primary care: prospective cohort study.

Angela Chung, Rafael Perera, Angela B Brueggemann, Abdel E Elamin, Anthony Harnden, Richard Mayon-White, Susan Smith, Derrick W Crook, David Mant

Registry-linked trialOpen access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03674775 (Dialogue Around Respiratory Illness Treatment for Family Practice), which is not on this map. Cited by 65 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 7 pooled it
12.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03674775 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Dialogue Around Respiratory Illness Treatment for Family Practice (DART -FP)

TypeinterventionalSponsorSeattle Children's HospitalRan2022 to 2026Enrolled180ConditionsAcute Respiratory Tract InfectionArmsDART QI Program Participation
3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 7 syntheses or guidelines pooled it, 141 citations in OpenAlex.

  1. β-Lactam-Resistant Streptococcus pneumoniae Dynamics Following Treatment: A Dose-Response Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
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5 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Angela ChungDepartment of Primary Health Care, NIHR School of Primary Care Research, University of Oxford, Oxford OX3 7LF.
Rafael Perera
Angela B Brueggemann
Abdel E Elamin
Anthony Harnden
Richard Mayon-White
Susan Smith
Derrick W Crook
David Mant
University of Oxford · GBJohn Radcliffe Hospital · GBPrimary Health Care · QA

Funding

Medical Research Council G0000340Medical Research Council G0400039
6 · The paper itself

Abstract

objectiveTo assess the effect of community prescribing of an antibiotic for acute respiratory infection on the prevalence of antibiotic resistant bacteria in an individual child. STUDY

designObservational cohort study with follow-up at two and 12 weeks.

settingGeneral practices in Oxfordshire.

participants119 children with acute respiratory tract infection, of whom 71 received a beta lactam antibiotic.

main outcome measuresAntibiotic resistance was assessed by the geometric mean minimum inhibitory concentration (MIC) for ampicillin and presence of the ICEHin1056 resistance element in up to four isolates of Haemophilus species recovered from throat swabs at recruitment, two weeks, and 12 weeks.

resultsPrescribing amoxicillin to a child in general practice more than triples the mean minimum inhibitory concentration for ampicillin (9.2 microg/ml v 2.7 microg/ml, P=0.005) and doubles the risk of isolation of Haemophilus isolates possessing homologues of ICEHin1056 (67% v 36%; relative risk 1.9, 95% confidence interval 1.2 to 2.9) two weeks later. Although this increase is transient (by 12 weeks ampicillin resistance had fallen close to baseline), it is in the context of recovery of the element from 35% of children with Haemophilus isolates at recruitment and from 83% (76% to 89%) at some point in the study.

conclusionThe short term effect of amoxicillin prescribed in primary care is transitory in the individual child but sufficient to sustain a high level of antibiotic resistance in the population.

Indexed as

AmoxicillinAmpicillinAnti-Bacterial Agentsbeta-Lactam ResistanceChildChild, PreschoolCohort StudiesDrug PrescriptionsFamily PracticeHaemophilus InfectionsHumansInfantMicrobial Sensitivity TestsPolymerase Chain ReactionPractice Patterns, Physicians'Prospective StudiesAmoxicillinAmpicillinAnti-Bacterial AgentsViral Envelope Proteins

Identifiers

PMID17656505
PMCPMC1962897
OpenAlexW2072862815

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.