Evidence map›Paper›PMID 30201827›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2018

Impact of antibiotics for children presenting to general practice with cough on adverse outcomes: secondary analysis from a multicentre prospective cohort study.

Niamh M Redmond, Sophie Turnbull, Beth Stuart, Hannah V Thornton, Hannah Christensen, Peter S Blair, Brendan C Delaney, Matthew Thompson, Tim J Peters, Alastair D Hay and 1 more

Erratum issuedAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Antibiotic effectiveness for children with lower respiratory infections: prospective cohort and trial in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Niamh M RedmondNational Institute for Health Research Collaborations for Leadership in Applied Health Research and Care West, Bristol, UK.
Sophie TurnbullCentre for Academic Primary Care.
Beth StuartPrimary Care and Population Sciences Unit, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, UK.
Hannah V ThorntonCentre for Academic Primary Care.
Hannah ChristensenPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Peter S BlairPopulation Health Sciences, Bristol Medical School, University of Bristol, St Michael's Hospital, Bristol, UK.
Brendan C DelaneyDepartment of Surgery and Cancer, Imperial College London, London, UK.
Matthew ThompsonDepartment of Family Medicine, University of Washington, Seattle, WA, US.
Tim J PetersBristol Medical School, University of Bristol, Southmead Hospital, Westbury-on-Trym, Bristol, UK.
Alastair D HayCentre for Academic Primary Care.
Paul LittlePrimary Care and Population Sciences Unit, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, UK.

Funding

Department of Health RP-PG-0608-10018
6 · The paper itself

Abstract

backgroundClinicians commonly prescribe antibiotics to prevent major adverse outcomes in children presenting in primary care with cough and respiratory symptoms, despite limited meaningful evidence of impact on these outcomes.

aimTo estimate the effect of children's antibiotic prescribing on adverse outcomes within 30 days of initial consultation. DESIGN AND

settingSecondary analysis of 8320 children in a multicentre prospective cohort study, aged 3 months to <16 years, presenting in primary care across England with acute cough and other respiratory symptoms.

methodBaseline clinical characteristics and antibiotic prescribing data were collected, and generalised linear models were used to estimate the effect of antibiotic prescribing on adverse outcomes within 30 days (subsequent hospitalisations and reconsultation for deterioration), controlling for clustering and clinicians' propensity to prescribe antibiotics.

resultsSixty-five (0.8%) children were hospitalised and 350 (4%) reconsulted for deterioration. Clinicians prescribed immediate and delayed antibiotics to 2313 (28%) and 771 (9%), respectively. Compared with no antibiotics, there was no clear evidence that antibiotics reduced hospitalisations (immediate antibiotic risk ratio [RR] 0.83, 95% confidence interval [CI] = 0.47 to 1.45; delayed RR 0.70, 95% CI = 0.26 to 1.90, overall

conclusionMost children presenting with acute cough and respiratory symptoms in primary care are not at risk of hospitalisation, and antibiotics may not reduce the risk. If an antibiotic is considered, a delayed antibiotic prescription may be preferable as it is likely to reduce reconsultation for deterioration.

Indexed as

AdolescentAnti-Bacterial AgentsChildChild, PreschoolCoughEnglandFemaleGeneral PracticeHospitalizationHumansInappropriate PrescribingInfantMalePractice Patterns, Physicians'Prospective StudiesRespiratory Tract InfectionsAnti-Bacterial Agentsadverse outcomesantibioticschildrencohort studiesprimary carerespiratory tract infections

Identifiers

PMID30201827
PMCPMC6145994

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Registered trials

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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.