Previous general practitioner consulting behaviour as a predictor of pneumonia in children

Abstract

To the Editor: As a consequence of increasing antimicrobial resistance, general practitioners (GPs) are encouraged to prescribe antibiotics only for patients most likely to benefit, for example children at high risk of hospitalisation for pneumonia. Secondary to clinical assessment, knowledge of a child's background may improve the identification of those at high risk, since several studies have described medical, social and environmental risk factors for paediatric community-acquired pneumonia. Most of these studies, including the only two case–control studies conducted in primary care [1], [2], compared cases of pneumonia with healthy community controls, and therefore may have identified risk factors for respiratory tract infections (RTIs) in general and not specifically pneumonia. Two case–control studies used hospital controls with RTIs [3], [4], but these findings may not be applicable to children consulting in primary care. We used an existing case–control study dataset [5] to explore demographic, medical and social risk factors for community-acquired pneumonia or empyema among children consulting in general practice. This is the first such comparison of children seen in primary care with RTIs with and without subsequent hospital presentation for pneumonia. The selection and recruitment of cases and controls and data collection procedures have been described elsewhere [5]. Cases were recruited from seven hospitals in south Wales, UK. Eligible cases were children aged 6 months …