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Delayed scripts slash antibiotic prescribing for children with otitis media

By Nigel Praities

Pioneering practices in Hertfordshire have shown antibiotic prescribing can be dramatically reduced for children with otitis media by providing delayed prescriptions.

The scheme has run in two practices from 1999 and resulted in the number of prescriptions for amoxicillin being cut by over half.

The scheme has been rolled out across South West Hertfordshire and has reduced amoxicillin prescriptions by 43% across the district in four years, compared with a 34% drop in the same period across the whole of England and Wales.

The Manor View and Attenborough practices in Bushey and Oxhey, south west Oxfordshire, targeted parents with children with earache and inflamed eardrums who were not unduly ill.

They routinely provided them with a patient handout describing the natural course of otitis media infection, advising them to use paracetamol for a few days and providing a delayed prescription for antibiotics.

NICE said GPs should consider issuing a delayed prescription for self-limiting respiratory tract infections in guidance issued last year.

Dr Chris Cates, a former GP at the Manor View practice and now a senior researcher at St George's Medical School, said the study showed delayed prescribing was effective for otitis media, but only in children who were not seriously ill.

‘Once the parents have tried it the first time and the child gets better then in the longer-term they don't immediately ring up and say "This child needs to be seen." They will use their own discretion and use painkillers first,' he said.

Dr Cates's results were published in this month's edition of Evidence Based Medicine and was described as ‘a delayed prescribing pioneer' by the Editor of the journal in the same issue.

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