Doctors commonly prescribe antibiotics to children who suffer from respiratory tract infections (RTI) with cough. Unfortunately, up to a third of these prescriptions are not necessary, which could pose problems because this contributes to bacteria adapting to antibiotics and eventually render medicines useless.

Doctors are likely to over-prescribe antibiotics for children because it is difficult to know if a child is at risk of developing more severe symptoms but a new decision making tool may help doctors prescribe antibiotics to children more efficiently reducing unnecessary use of antibiotics that could lead to antibiotic resistance.

In a new study, which was published in the journal Lancet Respiratory Medicine on Sept. 1, researchers used information of 8,400 children between three months to 16 years old to determine the most important factors in evaluating the necessity for antibiotics and eventually identified seven predictors that can be used to help determine if a child suffering from RTI and cough likely needs antibiotics.

The clinical tool called STARWAVe considers factors that healthcare providers can easily identify during a patient's visit and these include short illness, high temperature, below 2 years of age, wheezing, asthma, respiratory distress and moderate to severe vomiting over the past 24 hours.

Children who do not have more than one of these factors are considered to have very low likelihood of suffering from future complications. Researchers said that this rule needs to be externally validated through a randomized trial albeit this could be used to improve prescription of antibiotics to curb the growing problem of antibiotic resistance.

"The aim of our study was to develop a simple, usable prediction tool based on symptoms and signs to help [doctors] and nurses identify children presenting in primary care at the lowest and highest risk of future complications and hospitalization, so that antibiotics can be targeted accordingly," said study researcher Alastair Hay, from the University of Bristol in England.

By cutting the use of antibiotics in low risk children by half and even if antibiotic prescription is increased by 90 percent in high risk children at the same time, the clinical tool can potentially reduce antibiotic use among children with coughs and respiratory infections.

"Clinical characteristics can distinguish children at very low, normal, and high risk of future hospital admission for respiratory tract infection and could be used to reduce antibiotic prescriptions in primary care for children at very low risk," the researchers wrote in their study.

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