Two in five GPs pressured to prescribe antibiotics by childcare providers

Two out of five GPs say childcare providers' policies on conjunctivitis have pushed them to prescribe antibiotics to children, research has shown.

Some 43% of GPs say childcare provider policies have influenced their decision to prescribe antibiotics, while one in seven (15%) admitted it was the only reason they had prescribed antibiotics to a child, a poll of 200 GPs reveals.

A study published in the British Journal of General Practice (BJGP) also analysed policies from 164 childcare providers, finding that 87% excluded children with conjunctivitis and half (49%) specified a requirement for antibiotic treatment.

The policies go above and beyond Public Health England (PHE) recommendations which state that children with conjunctivitis do not need to be excluded from childcare.

Only 20% of the childcare provider policies said that no exclusion was required.

Those that did exclude children had a ‘considerable’ range of requirements, some only permitting children to return after ‘X days of antibiotics’ or ‘until symptom free’. Others stipulated that parents should take their child to their GP.

The researchers warned that the policies are generating ‘unnecessary consultations’ and thousands of prescriptions for antibiotics with ‘little demonstrable clinical or public health benefit’.

Antibiotic prescribing

Acute infective conjunctivitis (AIC) is common in preschool children, and usually mild and self-limiting. Only around 50-75% of cases are bacterial in origin.

One GP involved in the study said: ‘I have found it very frustrating feeling compelled to prescribe because working mothers tell me the child cannot attend nursery until they have been treated.’

But another said: ‘Antibiotics are given when needed. Childcare provider pressure does not work.’

The RCGP warned the self-imposed restrictions could have ‘serious implications’ for patients. Chairwoman Dr Maureen Baker said: ‘It’s concerning that nearly half of the childcare providers studied require children with AIC to have a prescription for antibiotics.

'This simply puts pressure on GPs to prescribe these drugs when they might not be necessary or appropriate.

‘These policies will also inevitably lead to unnecessary consultations at a time when GPs are under considerable workforce and resource pressures.

‘We would encourage closer working between health bodies, such as PHE and NICE, and childcare providers to develop more joined up policies, based in evidence, in the best interests of both individual patients and society at large.’

Photo: iStock

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