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Doubts persist over penicillin benefits

GPs are probably not doing children with suspected meningococcal disease any harm by

injecting them with penicillin before sending them to hospital, researchers have concluded.

But while the research eased concerns over the safety of parenteral penicillin, it failed to find evidence that following current guidelines was actually of benefit to patients.

The researchers echoed recent advice that GPs should focus on ensuring children were rushed to hospital as quickly as possible, and should not give penicillin if there was a risk it might cause delays.

Their systematic review of 14 observational studies, published in the BMJ last week, did not exclude the possibility that penicillin injections were harm- ful ­ as suggested by a recent study finding an increase in risk of death.

But it concluded the most likely explanation was that children given penicillin were already more severely ill, after finding evidence 'consistent with benefit' where a high

proportion of children were treated.

Study leader Dr Susan Hahne, medical epidemiologist at the National Institute for Public Health in the Netherlands, said: 'We cannot exclude the possibility that it might be harmful. But in these studies the harmful effect is confounded by severity.'

Medicolegal experts warned that GPs could face problems if they ignored the current guidance to give parenteral penicillin while arranging urgent transfer to hospital.

Dr Frances Szekley, senior medical claims handler at the Medical Defence Union, said: 'A doctor should take into account all current guidance and should think carefully before acting in contravention of national guidelines.'

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