Point-of-care decision rule for antibiotic prescriptions in young children with fever without source: an open cluster randomised trial.
David Malorey, Elsa Tavernier, Anne Drouard et al.
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In 30 seconds
This open cluster randomised trial evaluated a point-of-care decision rule aimed at reducing antibiotic prescriptions in children aged 6 days to 36 months with fever without source across 25 European emergency departments. The study found that 38.0% of children in the usual care group received antibiotics within 15 days compared to 26.2% in the decision rule group (OR 0.57; p<0.001), indicating a significant reduction in unnecessary antibiotic use.
Key findings
- 38.0% of children in the usual care group received antibiotics within 15 days.
- 26.2% of children in the decision rule group received antibiotics within 15 days.
- Serious bacterial infections occurred in 15.7% of children.
- Morbidity and mortality rates were similar between groups (OR 0.83; p=0.34).
Why it matters
Reducing unnecessary antibiotic prescriptions is crucial in combating antibiotic resistance. This study demonstrates that a structured decision rule can effectively minimize antibiotic use without compromising patient safety in young children presenting with fever without source.