Empyema rise as antibiotics fall

Rising rates of empyema among young children in the UK could be due to reduced antibiotic use by GPs, say experts.

Over the past 25 years rates of empyema have risen more than three-fold in children in Scotland, but the effect is independent of increasing rates of pneumonia, say researchers.

The findings are from a study of paediatric hospital admissions in Scotland for pneumonia and empyema between 1981 and 2005.

This showed that rates of empyema in the under-15s were stable until 1998, when a linear increase began to be seen.

Between 1998 and 2005, the rate of empyema admissions increased from fewer than 10 per million children per year to 37 per million children in 2005.

The problem is even more marked in children aged one to four. Up to 1998, the rate was around 6.5 per million per year, but by 2005 it was as high as 66 per million.

Overall admissions of pneumonia remained unchanged among most age groups. But in those aged one to four a steady increase was seen from 1981.

Similar increases in empyema have been reported in England.

Dr Kevin Gruffyd-Jones, Wiltshire GP and member of the General Practice Airways Group, said he has noticed an increase in empyema among young children in his practice.

'The reasons for this may be we're getting pathogenic organisms or that the pendulum has swung and we're diagnosing too many as being viral.

'There is a suggestion that we're overdiagnosing viral causes of pneumonia.'

Lead researcher of the study, Dr Stephen Turner, a consultant paediatrician at the Royal Aberdeen Children's Hospital, said: 'One potential solution is that GPs aren't prescribing enough antibiotics so we're seeing this rise.'

However, he added: 'I would have anticipated that if this was due to changes in GP prescribing we would have seen an increase in pneumonia, which we haven't.

'It could be that either the pathogen has got more virulent or the hosts have got more susceptible.'

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Just published

GMC sign

Gaps in GMC referral and exam pass rates for ethnic minority doctors falling, says GMC

Gaps in fitness to practise referrals and exam pass rates between doctors from white...

Pharmacy shelves

Menopause prescribing advice updated as HRT shortage continues

The British Menopause Society has recommended alternative options for prescribers...

GP sign

Using IIF cash to top up staff pay risks major gap in practice finances, warn accountants

GP practices could face a major cash shortfall in 2024/25 if they use investment...

Paxlovid – one of the treatments available for COVID-19

GPs could play bigger role in prescribing COVID-19 treatments from end of June

GPs could play a greater role in prescribing COVID-19 treatments to patients at risk...

Physiotherapist works with patient

Is the government right to claim its 26,000 additional roles target has been met?

Prime minister Rishi Sunak claimed last month that the government had met its manifesto...

Statement of fitness for work

GP training: Tips for completing FIT notes

GP trainer Dr Pipin Singh provides advice for trainees on how to complete fit notes,...