Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children: a systematic review and meta-analysis.

<h4>Background</h4>Respiratory tract infections (RTIs) are common in children and generally self-limiting, yet often result in consultations to primary care. Frequent consultations divert resources from care for potentially more serious conditions and increase the opportunity for antibio...

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Main Authors: Talley Andrews, Matthew Thompson, David I Buckley, Carl Heneghan, Rick Deyo, Niamh Redmond, Patricia J Lucas, Peter S Blair, Alastair D Hay
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0030334
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author Talley Andrews
Matthew Thompson
David I Buckley
Carl Heneghan
Rick Deyo
Niamh Redmond
Patricia J Lucas
Peter S Blair
Alastair D Hay
author_facet Talley Andrews
Matthew Thompson
David I Buckley
Carl Heneghan
Rick Deyo
Niamh Redmond
Patricia J Lucas
Peter S Blair
Alastair D Hay
author_sort Talley Andrews
collection DOAJ
description <h4>Background</h4>Respiratory tract infections (RTIs) are common in children and generally self-limiting, yet often result in consultations to primary care. Frequent consultations divert resources from care for potentially more serious conditions and increase the opportunity for antibiotic overuse. Overuse of antibiotics is associated with adverse effects and antimicrobial resistance, and has been shown to influence how patients seek care in ensuing illness episodes.<h4>Methodology/principal findings</h4>We conducted a systematic review and meta-analysis to assess the effectiveness of interventions directed towards parents or caregivers which were designed to influence consulting and antibiotic use for respiratory tract infections (RTIs) in children in primary care. Main outcomes were parental consulting rate, parental knowledge, and proportion of children subsequently consuming antibiotics. Of 5,714 references, 23 studies (representing 20 interventions) met inclusion criteria. Materials designed to engage children in addition to parents were effective in modifying parental knowledge and behaviour, resulting in reductions in consulting rates ranging from 13 to 40%. Providing parents with delayed prescriptions significantly decreased reported antibiotic use (Risk Ratio (RR) 0.46 (0.40, 0.54); moreover, a delayed or no prescribing approach did not diminish parental satisfaction.<h4>Conclusions</h4>IN ORDER TO BE MOST EFFECTIVE, INTERVENTIONS TO INFLUENCE PARENTAL CONSULTING AND ANTIBIOTIC USE SHOULD: engage children, occur prior to an illness episode, employ delayed prescribing, and provide guidance on specific symptoms. These results support the wider implementation of interventions to reduce inappropriate antibiotic use in children.
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spelling doaj-art-9ff41dfa9f5b4ee4a5eff41365cfe1f02025-06-28T05:31:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0171e3033410.1371/journal.pone.0030334Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children: a systematic review and meta-analysis.Talley AndrewsMatthew ThompsonDavid I BuckleyCarl HeneghanRick DeyoNiamh RedmondPatricia J LucasPeter S BlairAlastair D Hay<h4>Background</h4>Respiratory tract infections (RTIs) are common in children and generally self-limiting, yet often result in consultations to primary care. Frequent consultations divert resources from care for potentially more serious conditions and increase the opportunity for antibiotic overuse. Overuse of antibiotics is associated with adverse effects and antimicrobial resistance, and has been shown to influence how patients seek care in ensuing illness episodes.<h4>Methodology/principal findings</h4>We conducted a systematic review and meta-analysis to assess the effectiveness of interventions directed towards parents or caregivers which were designed to influence consulting and antibiotic use for respiratory tract infections (RTIs) in children in primary care. Main outcomes were parental consulting rate, parental knowledge, and proportion of children subsequently consuming antibiotics. Of 5,714 references, 23 studies (representing 20 interventions) met inclusion criteria. Materials designed to engage children in addition to parents were effective in modifying parental knowledge and behaviour, resulting in reductions in consulting rates ranging from 13 to 40%. Providing parents with delayed prescriptions significantly decreased reported antibiotic use (Risk Ratio (RR) 0.46 (0.40, 0.54); moreover, a delayed or no prescribing approach did not diminish parental satisfaction.<h4>Conclusions</h4>IN ORDER TO BE MOST EFFECTIVE, INTERVENTIONS TO INFLUENCE PARENTAL CONSULTING AND ANTIBIOTIC USE SHOULD: engage children, occur prior to an illness episode, employ delayed prescribing, and provide guidance on specific symptoms. These results support the wider implementation of interventions to reduce inappropriate antibiotic use in children.https://doi.org/10.1371/journal.pone.0030334
spellingShingle Talley Andrews
Matthew Thompson
David I Buckley
Carl Heneghan
Rick Deyo
Niamh Redmond
Patricia J Lucas
Peter S Blair
Alastair D Hay
Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children: a systematic review and meta-analysis.
PLoS ONE
title Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children: a systematic review and meta-analysis.
title_full Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children: a systematic review and meta-analysis.
title_fullStr Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children: a systematic review and meta-analysis.
title_full_unstemmed Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children: a systematic review and meta-analysis.
title_short Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children: a systematic review and meta-analysis.
title_sort interventions to influence consulting and antibiotic use for acute respiratory tract infections in children a systematic review and meta analysis
url https://doi.org/10.1371/journal.pone.0030334
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