TY - JOUR T1 - Child health care in general practice: priorities for education and practice JF - British Journal of General Practice JO - Br J Gen Pract SP - e207 LP - e208 DO - 10.3399/bjgp15X684253 VL - 65 IS - 633 AU - Peter J Gill AU - Matthew J Thompson Y1 - 2015/04/01 UR - http://bjgp.org/content/65/633/e207.abstract N2 - Children represent up to 25% of all consultations in UK general practice, but the spectrum of problems encountered is changing. While there is continued pressure for acute consultations for febrile illness, the number of serious bacterial infections is very small, and there has been an inexorable rise in non-communicable diseases.1 For example, hospital admissions for acute illness rose by 26% from 1999 to 20102 yet up to one-third of 10–11-year-olds in 2012–2013 in England were considered overweight or obese.3 Four articles published in this issue of the BJGP highlight aspects of child health in primary care and the challenges they present to GPs. These articles raise important issues about how primary care clinicians are trained in child health and the changing skills they now require for practice.Butler and colleagues prospectively studied the prevalence, diagnosis, and treatment of urinary tract infections (UTIs) in children aged 3 months to 5 years presenting with an acute illness to primary care.4 They found 339 children with a laboratory-proven UTI among 6079 children (5.6% prevalence). GPs only suspected UTI in one-third (31.7%) of children who ended up having one confirmed on culture, resulting in poor targeting of antibiotics. Further, only 26.0% of children ‘serendipitously’ treated were given the right antibiotic (that is, sensitive to cultured organism) compared to 77.1% of those with a suspected UTI.Of note, although there was a half-day faster symptom resolution, the overall recovery period was similar among children prescribed the right, the wrong (usually amoxicillin), or no antibiotic. It would be interesting to follow these children long term, particularly those prescribed none or inappropriate antibiotics, but there may be too few recurrent infections to assess long-term outcomes. Butler’s study highlights the need for better diagnosis and treatment targeting, possibly using point-of-care … ER -