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When children receive two or more prescriptions for antibiotics in a given year for common respiratory tract infections such as coughs, sore throat or earache, further antibiotic treatments are likely to be less effective, according to new research from the Universitys of Oxford, Cardiff and Southampton.

As many as thirty per cent of antibiotics prescribed to preschool children are unnecessary, and the consequences of overprescribing in terms of contributing to the concerning increase in antibiotic resistance have been widely publicised. The dangers of preschool children being given unnecessary antibiotics are becoming clearer.

In their study led by Dr Oliver van Hecke an NIHR Academic Clinical Lecturer and part-time GP in Oxford University's Nuffield Department of Primary Care Health Sciences, the researchers analysed information from the electronic patient records of over 250,000 preschool children held in the Clinical Practice Research Datalink.

They found that when two or more courses of antibiotics had been prescribed, failure of subsequent treatment, including the need for hospital referral and admission, was thirty per cent greater.

Reporting in the British Journal of General Practice, the researchers suggest that this may not simply be due to the emergence of resistant organisms or disruption of the microbiome, but may also be related to parental expectations of further treatment, coupled with a lack of awareness of the limited role of antibiotics and the expected duration of symptoms of common respiratory tract infections in children. 

"When children receive more antibiotics their likelihood of re-consulting a health professional is affected and inadvertently increases clinical workload."
Dr Oliver van Hecke, University of Oxford.

The study was funded by the Royal College of General Practitioners with support from the National Institute for Health Research.

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British Journal of General Practice 

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