Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.
Skip to main content

Background: Acute respiratory tract infections (RTI) in children are a common reason for antibiotic prescribing. Clinicians’ prescribing decisions are influenced by perceived parental expectations for antibiotics, however there is evidence that parents actually prefer to avoid antibiotics. This study aimed to investigate the influence of parent clinician communication on antibiotic prescribing for RTI in children in England. Methods: A mixed methods analysis of videoed primary care consultations for children (under 12 years) with acute cough and RTI. Consultations were video-recorded in six general practices in southern England, selected for socioeconomic diversity. 56 recordings were transcribed in detail and a subset of recordings and transcripts used to develop a comprehensive interaction-based coding scheme. The scheme was used to examine communication practices between parents and clinicians and how these related to antibiotic or non-antibiotic treatment strategies. Results: Parents’ communication rarely implied an expectation for antibiotics, some explicitly offering a possible viral diagnosis. Clinicians mostly gave, or implied, a viral diagnosis and mainly recommended non-antibiotic treatment strategies. In the minority of cases where parents’ communication behaviours implied they may be seeking antibiotic treatment, antibiotics were not usually prescribed. Where clinicians did prescribe antibiotics, they voiced concern about symptoms or signs, including chest pain, discoloured phlegm, prolonged fever, abnormal chest sounds, or pink /bulging ear drums. Conclusions: We found little evidence of a relationship between parents’ communication behaviours and antibiotic prescribing. Rather, where antibiotics were prescribed, this was associated with clinicians’ expressed concerns regarding symptoms and signs.

More information Original publication

DOI

10.1186/s12875-019-0993-9

Type

Journal article

Journal

BMC Family Practice

Issue

20:102

Publisher

BMC

Publication Date

19/07/2019

Addresses

Project 204

Keywords

Primary care, Antibiotics, Children, Parents, Communications, Conversation analysis, Respiratory tract, infections