Antibiotica bij hoestende kinderen?

Antibiotics are overprescribed for non-severe, lower respiratory tract infections (LRTI). A British general practice study shows that antibiotics do not shorten the duration of moderately bad symptoms in children presenting with presumed, uncomplicated LRTI. Important questions remain. The clinical diagnosis of pneumonia hampers badly. So who did the GPs dare to include for possible placebo treatment? The mean, normal body temperature, and the relatively high percentage of patients with an atopic background in the studied population may answer that question. Were antibiotics often prescribed for bronchial hyper reactivity instead of for actual infections? The low inclusion rate per GP suggests that this selected patient population has turned out to be different from the intended population. Tools that decrease diagnostic uncertainty and improve communication skills, combined with sincere compassion for the bothersome complaints probably help GPs, patients and their parents more to accept management without an antibiotic prescribed.

Conflict of interest and financial support: potential conflicts of interest have been reported for this article. ICMJE forms provided by the authors are available online along with the full text of this article.