Trial reportBMJ open2017
Factors predicting antibiotic prescription and referral to hospital for children with respiratory symptoms: secondary analysis of a randomised controlled study at out-of-hours services in primary care.
Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02496559 (Children With Fever and Respiratory Symptoms at Out-of-hours Services in Norway), which is not on this map. Cited by 21 papers, 3 of them syntheses that pooled 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.
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.
Children With Fever and Respiratory Symptoms at Out-of-hours Services in Norway
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Predicting poor outcomes in children aged 1-12 with respiratory tract infections: A systematic review.PloS one · 2021Pooled it
- In-vitro diagnostic point-of-care tests in paediatric ambulatory care: A systematic review and meta-analysis.PloS one · 2020Pooled it
- Impact of point-of-care C reactive protein in ambulatory care: a systematic review and meta-analysis.BMJ open · 2019Pooled it
- Improved diagnostic management of children with acute infections following the introduction of point-of-care C-reactive protein testing and general practitioner education in Latvia: aScandinavian journal of primary health care · 2026Trial
- Is C-reactive protein the answer to antibiotics over-prescribing in primary care? A behavioural experiment in two European countries.JAC-antimicrobial resistance · 2026Article
- Chronic tonsillitis and its potential alternative treatment: Exploration of the antibacterial activity of ethanolicNarra J · 2026Article
- Oral Antibacterial Drug Prescribing in Primary Care Out-of-Hours Services: A Scoping Review.Antibiotics (Basel, Switzerland) · 2025Review
- Outcomes of antibiotic treatment for respiratory infections in children an observational study in primary care.Scandinavian journal of primary health care · 2024Observational
- Positive Point-of-Care Influenza Test Significantly Decreases the Probability of Antibiotic Treatment during Respiratory Tract Infections in Primary Care.Diagnostics (Basel, Switzerland) · 2023Article
- C-reactive protein point-of-care testing and complementary strategies to improve antibiotic stewardship in children with acute respiratory infections in primary care.Frontiers in pediatrics · 2023Article
- Throat Swab Culture Positivity and Antibiotic Resistance Profiles in Children 2-5 Years of Age Suspected of Bacterial Tonsillitis at Hargeisa Group of Hospitals, Somaliland: A Cross-Sectional Study.International journal of microbiology · 2023Article
- Decreased Use of Broad-Spectrum Antibiotics During the Coronavirus Disease 2019 Epidemic in South Korea.The Journal of infectious diseases · 2021Article
- Risk prediction models to guide antibiotic prescribing: a study on adult patients with uncomplicated upper respiratory tract infections in an emergency department.Antimicrobial resistance and infection control · 2020Article
- Point-of-Care C-Reactive Protein Testing to Reduce Antibiotic Prescribing for Respiratory Tract Infections in Primary Care: Systematic Review and Meta-Analysis of Randomised Controlled Trials.Antibiotics (Basel, Switzerland) · 2020Review
- What out-of-hours antibiotic prescribing practices are contributing to antibiotic resistance: a literature review.British paramedic journal · 2020Article
- The impact of physicians' knowledge on outpatient antibiotic use: Evidence from China's county hospitals.Medicine · 2020Article
- Preschool children in Danish out-of-hours primary care: a one-year descriptive study of face-to-face consultations.BMC family practice · 2019Article
- Antibiotic use for acute respiratory tract infections (ARTI) in primary care; what factors affect prescribing and why is it important? A narrative review.Irish journal of medical science · 2018Review
- Article
- Relationship between Maternal and First Year of Life Dispensations of Antibiotics and Antiasthmatics.Antibiotics (Basel, Switzerland) · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAcute respiratory infections and fever among children are highly prevalent in primary care. It is challenging to distinguish between viral and bacterial infections. Norway has a relatively low prescription rate of antibiotics, but it is still regarded as too high as the antimicrobial resistance is increasing. The aim of the study was to identify predictors for prescribing antibiotics or referral to hospital among children.
designSecondary analysis of a randomised controlled study.
setting4 out-of-hours services and 1 paediatric emergency clinic in Norwegian primary care.
participants401 children aged 0-6 years with respiratory symptoms and/or fever visiting the out-of-hours services. OUTCOMES: 2 main outcome variables were registered: antibiotic prescription and referral to hospital.
resultsThe total prescription rate of antibiotics was 23%, phenoxymethylpenicillin was used in 67% of the cases. Findings on ear examination (OR 4.62; 95% CI 2.35 to 9.10), parents' assessment that the child has a bacterial infection (OR 2.45; 95% CI 1.17 to 5.13) and a C reactive protein (CRP) value >20 mg/L (OR 3.57; 95% CI 1.43 to 8.83) were significantly associated with prescription of antibiotics. Vomiting in the past 24 hours was negatively associated with prescription (OR 0.26; 95% CI 0.13 to 0.53). The main predictors significantly associated with referral to hospital were respiratory rate (OR 1.07; 95% CI 1.03 to 1.12), oxygen saturation <95% (OR 3.39; 95% CI 1.02 to 11.23), signs on auscultation (OR 5.57; 95% CI 1.96 to 15.84) and the parents' assessment before the consultation that the child needs hospitalisation (OR 414; 95% CI 26 to 6624).
conclusionsCRP values >20 mg/L, findings on ear examination, use of paracetamol and no vomiting in the past 24 hours were significantly associated with antibiotic prescription. Affected respiration was a predictor for referral to hospital. The parents' assessment was also significantly associated with the outcomes. TRIAL REGISTRATION NUMBER: NCT02496559; Results.
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