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Research ArticleOriginal Research

Antibiotic Prescription in Febrile Children: A Cohort Study during Out-of-Hours Primary Care

Gijs Elshout, Marijke Kool, Johannes C. Van der Wouden, Henriëtte A. Moll, Bart W. Koes and Marjolein Y. Berger
The Journal of the American Board of Family Medicine November 2012, 25 (6) 810-818; DOI: https://doi.org/10.3122/jabfm.2012.06.110310
Gijs Elshout
the Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands; Erasmus MC Rotterdam; and Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
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Marijke Kool
the Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands; Erasmus MC Rotterdam; and Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
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Johannes C. Van der Wouden
the Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands; Erasmus MC Rotterdam; and Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
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Henriëtte A. Moll
the Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands; Erasmus MC Rotterdam; and Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
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Bart W. Koes
the Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands; Erasmus MC Rotterdam; and Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
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Marjolein Y. Berger
the Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands; Erasmus MC Rotterdam; and Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
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Abstract

Background: Fever is common in children and often self-limiting, nevertheless antibiotics are frequently prescribed. We determined how often antibiotics were prescribed in children presenting with fever at a family physicians' out-of-hours service and established the children's signs and symptoms related to antibiotic prescriptions.

Patients: Children aged 3 months to 6 years with fever as the main reason for contact.

Results: Of the 443 included children, 322 children had a face-to-face contact at the out-of-hours service. Of these, 117 (36.3%) were prescribed antibiotics, that is, 26.5% of the total study population. Concerned parents (OR, 2.02; 95% CI, 1.06–3.58), ill appearance (3.26; 1.30–8.20), earache resulting in altered behavioral or sleeping patterns (2.59; 1.06–6.30), signs of throat infection (2.37; 1.35–4.15), and decreased urine production (2.00; 1.17–3.41) were positively associated with antibiotic prescription. A negative association was found for age 3 to 6 months (0.17; 0.03–0.74) and temperature (0.52; 0.37–0.71).

Conclusions: Antibiotics were prescribed in 1 out of 4 febrile children whose parents contacted the out-of-hours service. Items associated with antibiotic prescription provide insight into the family physicians' decision-making process when assessing children with fever. These can be used as targets for strategies to diminish antibiotic prescription.

  • Antibiotics
  • Child
  • Family in Family Medicine
  • Family Medicine
  • Fever
  • Infectious Diseases
  • Pediatrics
  • Primary Health Care
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The Journal of the American Board of Family     Medicine: 25 (6)
The Journal of the American Board of Family Medicine
Vol. 25, Issue 6
November-December 2012
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Antibiotic Prescription in Febrile Children: A Cohort Study during Out-of-Hours Primary Care
Gijs Elshout, Marijke Kool, Johannes C. Van der Wouden, Henriëtte A. Moll, Bart W. Koes, Marjolein Y. Berger
The Journal of the American Board of Family Medicine Nov 2012, 25 (6) 810-818; DOI: 10.3122/jabfm.2012.06.110310

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Antibiotic Prescription in Febrile Children: A Cohort Study during Out-of-Hours Primary Care
Gijs Elshout, Marijke Kool, Johannes C. Van der Wouden, Henriëtte A. Moll, Bart W. Koes, Marjolein Y. Berger
The Journal of the American Board of Family Medicine Nov 2012, 25 (6) 810-818; DOI: 10.3122/jabfm.2012.06.110310
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Keywords

  • Antibiotics
  • Child
  • Family in Family Medicine
  • Family Medicine
  • Fever
  • Infectious Diseases
  • Pediatrics
  • Primary Health Care

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