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‘Unnecessary’ antibiotics scripts for child conjunctivitis

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Antibiotics are being unnecessarily prescribed for conjunctivitis in children, according to UK researchers.

A study by the University of Birmingham found that a number of policies used by childcare providers for conjunctivitis are contrary to national guidance.

“These policies lead to unnecessary primary care consultations”

Samuel Finnikin

They were leading to the unnecessary prescription of antibiotics and the exclusion of children from nurseries, warned the study authors.

They noted that Public Health England’s guidance stated that children with acute infective conjunctivitis do not need to be excluded or necessarily treated with antibiotics.

But 86.7% of the 164 nursery schools they surveyed had policies to exclude children and 49.4% specified a requirement for antibiotic treatment before a child could be readmitted.

In addition, the study involved the results of a survey of 200 general practitioners, registrars and nurse prescribers.

It found 42.6% had their prescribing of topical antibiotics for acute infectious conjunctivitis influenced by childcare provider policies, and 15.4% stated that such policies were the only reason for prescribing antibiotics.

There is little evidence of a clinically relevant effect of topical antibiotic treatment on acute infectious conjunctivitis in children, said the researchers.

Though topical chloramphenicol shortens the duration of symptoms by only 0.3 days, many clinicians prescribe antibiotics, they noted in the British Journal of General Practice.

Lead author Dr Samuel Finnikin, from the University of Birmingham, said: “What we are seeing is a huge discrepancy between Public Health England guidelines and the policies of nurseries.

“These policies lead to unnecessary primary care consultations and thousands of unnecessary prescriptions for antibiotics, not to mention the inconvenience for parents and children,” he said.

Professor Kate Jolly, also from Birmingham University, suggested that the nursery policies could give parents an unrealistic view of the benefit of antibiotics.

The study of sickness policies in childcare providers is the most comprehensive to date in terms of the number and variety of providers included.

However, the authors acknowledged that, with approximately 25,000 UK registered nurseries, the 164 surveyed represents a relatively small fraction.

 

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