TY - JOUR T1 - Clinical predictors of antibiotic prescribing for acutely ill children in primary care: an observational study JF - British Journal of General Practice JO - Br J Gen Pract SP - e585 LP - e592 DO - 10.3399/bjgp15X686497 VL - 65 IS - 638 AU - Kathryn O’Brien AU - Thomas Wyn Bellis AU - Mark Kelson AU - Kerenza Hood AU - Christopher C Butler AU - Adrian Edwards Y1 - 2015/09/01 UR - http://bjgp.org/content/65/638/e585.abstract N2 - Background Antibiotic overuse and inappropriate prescribing drive antibiotic resistance. Children account for a high proportion of antibiotics prescribed in primary care.Aim To determine the predictors of antibiotic prescription in young children presenting to UK general practices with acute illness.Design and setting Prospective observational study in general practices in Wales.Method A total of 999 children were recruited from 13 practices between March 2008 and July 2010. Multilevel, multivariable logistic regression analysis was performed to determine predictors of antibiotic prescribing.Results Oral antibiotics were prescribed to 261 children (26.1%). Respiratory infections were responsible for 77.4% of antibiotic prescriptions. The multivariable model included 719 children. Children were more likely to be prescribed antibiotics if they were older (odds ratio [OR] 1.3; 95% confidence intervals [CI] = 1.1 to 1.7); presented with poor sleep (OR 2.7; 95% CI = 1.5 to 5.0); had abnormal ear (OR 6.5; 95% CI = 2.5 to 17.2), throat (OR 2.2; 95% CI = 1.1 to 4.5) or chest examination (OR 13.6; 95% CI = 5.8 to 32.2); were diagnosed with lower respiratory tract infection (OR 9.5; 95% CI = 3.7 to 25.5), tonsillitis/sore throat (OR 119.3; 95% CI = 28.2 to 504.6), ear infection (OR 26.5; 95% CI = 7.4 to 95.7) or urinary tract infection (OR 12.7; 95% CI = 4.4 to 36.5); or if the responsible clinician perceived the child to be moderately to severely unwell (OR 4.0; 95% CI = 1.4 to 11.4). The area under the receiver operating characteristic curve was 0.9371.Conclusion Respiratory infections were responsible for 74.4% of antibiotic prescriptions. Diagnoses of tonsillitis, sore throat, or ear infection were associated most with antibiotic prescribing. Diagnosis seemed to be more important than abnormal examination findings in predicting antibiotic prescribing, although these were correlated. ER -