Antibiotic prescribing rates are not affected (to a statistically significant degree) when physicians have access to a parent-focused booklet on childhood fever but do decrease if the booklet is used. As part of a two-armed cluster-randomized trial at 20 out-of-hours general practice centers in The Netherlands, family physicians in the intervention group had access to a booklet on children's fever. The booklet, designed to be used in discussion with parents, provided advice on when to consult a family physician, self-management strategies, and the duration of common childhood infections. The study included 25,355 children. Antibiotic prescribing was not significantly different in the intervention and control groups, however, after adjusting for compliance (use of the booklet), there was a significant reduction in antibiotic prescribing in children managed by a family physician using the booklet (n=3407) compared to children in the control group. Children in the intervention group were also less likely to receive a prescription for any medication, including non-antibiotic medication. Although the reduction in antibiotic prescribing in this implementation study was modest, the authors suggest that it provides evidence of the likely 'real world' benefits and efficacy of the intervention and its relevance to efforts to reduce antimicrobial resistance.
Booklet for Childhood Fever In Out-of-Hours Primary Care: A Cluster Randomized Controlled Trial
Jochen WL Cals, MD, PhD, et al
Maastricht University, Maastricht, The Netherlands