Primary care clinician antibiotic prescribing decisions in consultations for children with RTIs: a qualitative interview study

Jeremy Horwood; Christie Cabral; Alastair D Hay; Jenny Ingram

doi:10.3399/bjgp16X683821

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The "Grey area"
Oliver Penney

Published on: 16 March 2016

Published on: (16 March 2016)

The "Grey area"
Oliver Penney, GP,, Weobley Surgery
I was very interested to read this article and as GPs we all recognise the “grey area”. As a rural GP of 24 years I agree that “ in 80% of children with RTIs are well and perhaps 5% are really unwell “ as GPs we all know that in these cases management does not usually present a challenge but the other 15% - the grey area it can be more difficult.

Last year I studied 99 cases of cough presenting in Rural General Practice from the age of 5-75; I used a point of care CRP test and a scoring system and found that only 1:5 needed antibiotics which corresponds very closely with the quote in the article.

I believe that the grey area is exactly where the POC CRP test can fit in to the GPs armoury.

The test only takes 4 minutes and is easy to fit into a normal consultation. It is a finger prick and therefore although some children said “it hurt slightly” this more than compensated for by the fascination they showed in the machine. In fact it proved to be a great educational tool and provided a focus to talk about and hopefully learn a bit about viruses and bacteria. In general it was very well tolerated.

It has already been shown that POC CRP testing does help to reduce antibiotic prescribing in primary care, and it is widely used in several European countries (Norway and the Netherlands for instance). M...
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I was very interested to read this article and as GPs we all recognise the “grey area”. As a rural GP of 24 years I agree that “ in 80% of children with RTIs are well and perhaps 5% are really unwell “ as GPs we all know that in these cases management does not usually present a challenge but the other 15% - the grey area it can be more difficult.

Last year I studied 99 cases of cough presenting in Rural General Practice from the age of 5-75; I used a point of care CRP test and a scoring system and found that only 1:5 needed antibiotics which corresponds very closely with the quote in the article.

I believe that the grey area is exactly where the POC CRP test can fit in to the GPs armoury.

The test only takes 4 minutes and is easy to fit into a normal consultation. It is a finger prick and therefore although some children said “it hurt slightly” this more than compensated for by the fascination they showed in the machine. In fact it proved to be a great educational tool and provided a focus to talk about and hopefully learn a bit about viruses and bacteria. In general it was very well tolerated.

It has already been shown that POC CRP testing does help to reduce antibiotic prescribing in primary care, and it is widely used in several European countries (Norway and the Netherlands for instance). My own experience showed me that it is in the grey area that it can be of particular help to GPs.

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Competing Interests: None declared.