Antibiotic prescription in febrile children: A cohort study during out-of-hours primary care

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.