What are the causes of unnecessary antibiotic prescribing?

 

 

By Christie Cabral, Research Fellow, Centre for Academic Primary Care, University of Bristol

Why do parents seeking evaluation, reassurance and information about their child’s cough end up with antibiotics from their GP? Research fellow Christie Cabral looks at the evidence.

GPs see a lot of children with respiratory tract infections (RTIs), usually presenting with a cough, high temperature or both. RTIs can be distressing and disruptive for children and parents but are mostly viral illnesses that will get better on their own: there is little that a GP can do to treat them.

However, many are prescribed unnecessary antibiotics that can lead to resistant bacteria. From our previous research, we know that parents often feel uncertain about the severity of an RTI and feel that it’s safer to consult a doctor.

They are usually seeking a medical evaluation, reassurance and information to help them understand and … Read more

What’s normal in children’s respiratory infections? Bristol parents helped us find out

 

by Dr Emma Anderson
Senior Research Associate
Centre for Academic Primary Care

As any parent knows, children get coughs, colds and ear infections all the time. Symptoms of these respiratory infections – including runny nose, cough and sore throat – can seem never-ending.

In the EEPRIS Study, led by Professor Alastair Hay from the University of Bristol’s Centre for Academic Primary Care, we recruited parents across Bristol to tell us about their children’s respiratory symptoms as they became ill. Gathering information in the community means we are able to find out more about common respiratory illnesses than when we study those who have decided to consult their GP. It also gives us a more accurate picture of how likely parents are to consult for these common illnesses, something which has been surprisingly unclear.

Two of our main findings were that:

  • it takes up to three weeks for most
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Penicillin was discovered 90 years ago – and despite resistance, the future looks good for antibiotics

 

by Professor Alastair Hay
Professor of Primary Care
Centre for Academic Primary Care

When the NHS turned 70 this year, I was reminded of another anniversary which has had an enormous impact on healthcare over many years. Penicillin is 90 this year.

Discovered in September 1928 by Alexander Fleming, it was first used as a cure when George Paine treated eye infections with it in 1930. A method for mass production was devised by Howard Florey and Ernst Chain in 1940, and it was first mass produced in 1942, with half of that total supply used for one patient being treated for streptococcal septicaemia.

In 1944, 2.3m doses were produced in time for the Normandy landings of World War II. And it was then that the miracle of penicillin became clear. Soldiers who had previously died from septicaemia were surviving.

Expectations rose. If penicillin could cure septicaemia, what … Read more

Why are so many children given antibiotics for a cough?

Christie CabralBy Dr Christie Cabral
Research Associate
Centre for Academic Primary Care

When I first started researching infectious cough in children, lots of clinicians told me they couldn’t understand why so many parents brought in children who were well enough to turn the consulting room upside down before they even started the examination. As a parent of two young children myself, I had some idea, but as a qualitative researcher, I was keen to get a balanced view.

In the TARGET Programme* we wanted to answer two questions. Given that most coughs will get better on their own:

1) Why do so many parents consult when their child has a cough?
2) Why do so many clinicians prescribe antibiotics for children with coughs?

We conducted five qualitative studies and began to notice common themes, not just across the studies but also shared by parents and clinicians. We found normative beliefs Read more