1 van de Maat J

van de Voort E

Mintegi S

et al. Antibiotic prescription for febrile children in European emergency departments: a cross-sectional, observational study.

In their cross-sectional study of 5177 children admitted to 28 emergency departments across Europe between Nov 1, 2014, and Feb 28, 2016, Josephine van de Maat and colleaguesreport in The Lancet Infectious Diseases that 1454 (32%) of 4560 children without comorbidities were given a course of antibiotics on discharge. The variation in prescription frequency across countries was vast, from 19% (81 of 428 children received antibiotics) in Switzerland to 64% (450 of 708) in Turkey. The authors focused their analysis on respiratory tract infections, which accounted for 82% of all antibiotic prescriptions, to identify factors affecting prescription decisions. Duration of fever, elevated C-reactive protein concentration, focal abnormalities, or, to a lesser degree, diffuse abnormalities in chest X-rays were associated with increased prescribing but these factors did not fully explain the variance in the model. The authors hypothesised that other factors they did not include might be contributing. However, the high frequency of prescriptions also raises the issue of irrationality toward prescribing antibiotics.