Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children: A systematic review and Meta-Analysis

Talley Andrews, Matthew Thompson, David Buckley, Carl Heneghan, Richard (Rick) Deyo, Niamh Redmond, Patricia J. Lucas, Peter S. Blair, Alastair D. Hay

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

Background: 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. Methodology/Principal Findings: 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. Conclusions: 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.

Original languageEnglish (US)
Article numbere30334
JournalPLoS One
Volume7
Issue number1
DOIs
StatePublished - Jan 27 2012

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systematic review
meta-analysis
Respiratory Tract Infections
respiratory tract diseases
Meta-Analysis
antibiotics
Anti-Bacterial Agents
Parents
Primary Health Care
Referral and Consultation
patient care
relative risk
health care workers
antibiotic resistance
Caregivers
Prescriptions
Patient Care
adverse effects
Odds Ratio

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children : A systematic review and Meta-Analysis. / Andrews, Talley; Thompson, Matthew; Buckley, David; Heneghan, Carl; Deyo, Richard (Rick); Redmond, Niamh; Lucas, Patricia J.; Blair, Peter S.; Hay, Alastair D.

In: PLoS One, Vol. 7, No. 1, e30334, 27.01.2012.

Research output: Contribution to journalArticle

Andrews, Talley ; Thompson, Matthew ; Buckley, David ; Heneghan, Carl ; Deyo, Richard (Rick) ; Redmond, Niamh ; Lucas, Patricia J. ; Blair, Peter S. ; Hay, Alastair D. / Interventions to influence consulting and antibiotic use for acute respiratory tract infections in children : A systematic review and Meta-Analysis. In: PLoS One. 2012 ; Vol. 7, No. 1.
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