• Question: Is there a case for antibiotic use in children to be limited to hospitals with careful exemptions (eg. established chronic conditions, probable or confirmed GAS throat)? Alternatively, is there any evidence that GPs with special-interest in paediatrics would reduce antibiotic use in this age-group?

    Asked by Anon on 15 Nov 2015.
    • Photo: Cliodna McNulty

      Cliodna McNulty answered on 17 Nov 2015:

      No I do not think this would be appropriate. It is important for GPs to be able to give antibiotics when needed.
      Sharing the When Should I Worry booklet with parents and carers of children, will help educate them about when antibiotics are needed and when parents and carers should seek help.
      Go to /www.whenshouldiworry.com/ to have a look!

    • Photo: Christopher Butler

      Christopher Butler answered on 18 Nov 2015:

      The problem of regulating the use of antibiotics too tightly is that clinicians may follow the regulation at the expense of taking the whole clinical picture into account.

      It would be better to consider the clinical findings in relation to the evidence about risks and benefits and discuss this with the parent and to make a good handover plan with specific information about what parents should do if specific signs develop (such as breathing fast). Most parents do not want their children to take antibiotics when the risk of harm is about as great as the risk of mild benefit! Communication as always is the key!

    • Photo: Adam Roberts

      Adam Roberts answered on 14 Nov 2016:

      One consequence of any restriction is a change in the supply network of antibiotics to users. A recent study by Dr Faye Kirkland that I was peripherally involved with showed a dramatic increase in searches for online (UK based) pharmacies where you can easily obtain highly inappropriate antibiotics. This correlates well with lower prescibing rates and more difficulty obtaining antibiotics from your GP.

      The study is described here;