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The waiting game

Media reports of sepsis deaths 'make parents pressure GPs for antibiotics'

Emotive newspaper coverage of children who have died from sepsis may put GPs under extra pressure to prescribe antibiotics when the drugs are not clinically necessary, new research has suggested.

Analysis of UK news coverage of childhood sepsis between 1988 and 2018 showed ‘a picture presented to a public audience of a vast and previously unseen death toll’ related to the condition, said the study, published in the British Journal of General Practice.

Researchers looked at 140 articles in 12 newspapers and found stories commonly reported on children who had died after being told they did not require treatment by healthcare professionals.

In addition, previously healthy children were presented in news stories as disproportionately at risk of sepsis, which the researchers said is out of keeping with the known epidemiology of the condition.

Parents were presented as being 'ultimately responsible' for ensuring clinicians spot their child's symptoms of sepsis - and ensuring healthcare professionals did not block access to antibiotics for the condition, said the paper.

There have been national public campaigns to increase awareness of the signs of sepsis, but at the same time there has also been a drive to ensure GPs avoid ununnecessary antibiotic prescribing, in a bid  to cut antibiotic resistance.

The study team noted a widely reported sepsis case in the media, involving one-year-old William Mead, who died of sepsis associated with an untreated streptococcal infection. This was followed by a 'plethora' of similar articles.

An NHS England enquiry into the case of William concluded that pressure on GPs to avoid prescribing antibiotics may have contributed to his death, said the researchers. 

This type of narrative has the potential to damage efforts to promote antimicrobial stewardship and increase the likelihood of antimicrobial prescribing that is not clinically justified, the researchers concluded.

Study leader Dr Lynne Rush, a clinical research fellow at the University of Glasgow, said better awareness of sepsis was essential.

But she added: ‘However, media messages about the importance of early treatment with antibiotics in managing sepsis are rarely incorporated warnings about the health risks associated with overuse.

‘Public health communications about sepsis awareness must acknowledge the wider implications of unnecessary antibiotic use as a driver of antimicrobial resistance, and ensure effective treatment for sepsis in the longer term.’

Professor Azeem Majeed, professor of primary care at Imperial College London, said conflicting media messages could cause confusion amongst patients.

He said: ‘On the one hand, there are messages about serious infections such as sepsis and the need to get prompt diagnosis and treatment; and then there are messages about over-use of antibiotics and the threats from antibiotic resistance. 

‘This also creates problems for doctors as the consequences for missing sepsis and other major infections are serious for patients - but at the same time, there is considerable pressure on doctors to prescribe fewer antibiotics.’

Readers' comments (9)

  • A case of missed sepsis can easily be traced to a single GP who is then shafted. Deaths due to anti microbial resistance in 20 years time can’t be easily traced to Individual prescription happy GPs. So we keep prescribing....

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  • Vinci Ho

    I blame academics and authority spokesmen creating the confusion when they were interviewed by various media . The reality at the frontline ,where GPs are faced with this dilemma , is never addressed when they open their mouth to these reporters.
    Clearly , one minute the headline is the judgement day dominated by some apocalyptic infections totally unresponsive to any antibiotics. Next minute we have sepsis is killing so many people every minute . The two headlines simply do not add up as far as understanding the difficulties frontline GPs are facing everyday is concerned .
    As a patient or parent , you can easily imagine that all he or she wants is to have ‘correct’ advice and/or treatment to get better (obviously, avoid death !). You just wish these so called authorities would put themselves in other people’s shoes before they open their gob next time !👿😈
    Again , stop interfering and undermining the role of grass-root GPs

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  • David Banner

    I deliberately put the “it’s just a virus, you don’t need antibiotics” poster right next to the “Sepsis - you need antibiotics NOW!” poster in our waiting room as the symptoms were remarkably similar!!
    The very definition of “damned if you do, damned if you don’t “.

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  • I like you move David Banner!

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  • 6 million deaths a year due to sepsis worldwide, over 700,000 deaths due to antibiotics resistance and rising. 3 out 10 cases of sepsis are due to drug resistant bacteria. most cases in low or middle income countries, most child deaths worldwide associated with maternal sepsis and childbirth. sepsis is a failure of the immune systems normal coping mechanisms for eradicating infection. a recent study showed that 60% of patients abuse GPs to get antibiotics and 80% will try and access them elsewhere if not given by their GP. 11% of the UK population were unaware of antibiotic resistance and its issues. Basically, if you get sepsis your immune system is not working properly, if its badly damaged no amount of antibiotics will save you. when we run out of antibiotics that work, currently 30% of e coli are resistant to trimethoprim in the UK, then these people will either live or die. it will depend on how good your DNA is.to sort the mess out needs a lead by the DoH on what we should and should not so and any blame for any deaths taken on by a no fault scheme rather than criticising those that follow the guidelines. its not difficult to do but it does need leadership.

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  • DrRubbishBin

    I think there is a general mid-representation of what sepsis is. 'd in vadar' above describes it very well. Sepsis is a process that develops as a consequence of events leading up to it , it's a failure of the immune system that is overwhelmed, usually resulting from multiple factors. Anyone reading mainstream coverage would think it's a specific disease - its not it's a peri end stage pathological process. This confusion doesn't help. There had been too much politics in this issue - it was a particular 'issue' for Jeremy Hunt because of an individual case he was closely involved with. Sepsis became a political flag for the previous health secretary and as with so much of his legacy this isn't helping.

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  • DrRubbishBin

    Mis-representation not mid-representation (auto correct at it again) 🧐

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  • Knew this would happen. The anti antibiotic group and the anti sepsis group need to put their heads together to come up with a public message which does not polarise the issue. Something like: Sepis is a rare but rapidly fatal condition that needs early identification and antibiotic treatment for cure. Using precious antibiotics for common self limiting illness makes it less likely that you or a family member will survive sepsis and will not prevent its occurrence. Do not badger your GP or health care worker for antibiotics. They will know when they need to be prescribed. The symptoms of sepsis are: a b c d. The people who get it tend to be: w x y z. The action you need to take if you suspect sepsis is: k l m n.

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  • Katharine Morrison

    well said katharine !

    what a sensible person !

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