Nursery sickness policies and their influence on prescribing for conjunctivitis: audit and questionnaire survey

Finnikin, Samuel; Jolly, Kate

doi:10.3399/bjgp16x686125

Cited by 9 publications

(6 citation statements)

References 19 publications

(32 reference statements)

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“…). In a recent UK study, 87% of childcare policies excluded children with conjunctivitis and 49% required antibiotic treatment, with 43% of healthcare providers reporting to be influenced by childcare polices when prescribing antibiotics and 15% reporting childcare polices to be the sole reason for prescribing (Finnikin & Jolly ). In Denmark, topical ocular antibiotics are often prescribed to children via telephone consultations and during weekends through out‐of‐hours primary care, that is, without clinical consultations (Huibers et al.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of topical ocular antibiotics in young children: a Scandinavian drug utilization study

Andersson

Hofsli

Gade

et al. 2018

Acta Ophthalmologica

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Section: Discussionmentioning

confidence: 99%

“…). Nevertheless, school and day care policies often dictate that children must receive antibiotic treatment before being allowed to return (Finnikin & Jolly ). Consequently, parents exert a substantial pressure on the medical doctor to obtain treatment for their child (Rose et al.…”

Section: Introductionmentioning

confidence: 99%

Use of topical ocular antibiotics in young children: a Scandinavian drug utilization study

Andersson

Hofsli

Gade

et al. 2018

Acta Ophthalmologica

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“…Patients' expectations and preference for antibiotics may be important factors, particularly given the perceived infectivity of conjunctivitis in leading to work and school exclusion, despite a lack of evidence for these exclusionary policies. 36 Additionally, GP trainees may find management of ophthalmological problems particularly challenging. 10 A lack of clinical confidence in managing the condition, including lack of diagnostic confidence, fear of possible complications and perceived patient dissatisfaction with lack of prescribing, may also be important factors in registrars' prescribing for conjunctivitis, as they are for respiratory infections.…”

Section: Implications For Clinical and Educational Practicementioning

confidence: 99%

Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis

Cherry

Tapley

Quain

et al. 2021

J. Prim. Health Care

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INTRODUCTION: Over-prescription of antibiotics for common infective conditions is an important health issue. Infective conjunctivitis represents one of the most common eye-related complaints in general practice. Despite its self-limiting nature, there is evidence of frequent general practitioner (GP) antibiotic prescribing for this condition, which is inconsistent with evidence-based guidelines. AIM: To investigate the prevalence and associations of GP registrars' (trainees') prescription of antibiotics for infective conjunctivitis. METHODS: We performed a cross-sectional analysis of the Registrar Encounters in Clinical Training (ReCEnT) ongoing prospective cohort study, which documents GP registrars' clinical consultations (involving collection of information from 60 consecutive consultations, at three points during registrar training). The outcome of the analyses was antibiotic prescription for a new diagnosis of conjunctivitis. Patient, registrar, practice and consultation variables were included in uni-and multivariable logistic regression analyses to test associations of these prescriptions. RESULTS: In total, 2333 registrars participated in 18 data collection rounds from 2010 to 2018. There were 1580 new cases of infective conjunctivitis (0.31% of all problems). Antibiotics (mainly topical) were prescribed in 1170 (74%) of these cases. Variables associated with antibiotic prescription included patients' Aboriginal or Torres Strait Islander status, registrar organisation of a follow up (both registrar and other GP follow up), and earlier registrar training term (more junior status). DISCUSSION: GP registrars, like established GPs, prescribe antibiotics for conjunctivitis in excess of guideline recommendations, but prescribing rates are lower in later training. These prescribing patterns have educational, social and economic consequences. Further educational strategies may enhance attenuation of registrars' prescribing during training.

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“…While bacterial conjunctivitis will resolve by itself, antimicrobials can be prescribed to shorten the duration of illness 23. Furthermore, many child care providers exclude children with conjunctivitis until antibiotic treatment is provided and this has been shown to impact the decision to prescribe antibiotics 24. Moreover, it is difficult clinically to differentiate viral from bacterial conjunctivitis, so providers tend to “err on the side of safety” and prescribe antibiotics “just in case” 20…”

Section: Discussionmentioning

confidence: 99%

<p>The epidemiology and treatment of conjunctivitis at Urgent Care Centres in Israel</p>

Gordon‐Shaag¹,

Zimmerman

Shneor³

2019

OPTH

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Purpose: Conjunctivitis is the most common ocular condition diagnosed at emergency departments (ED) in the USA, although it is generally not an emergent condition. Treatment of conjunctivitis at Urgent Care Centres (UCC) could offer lower cost than ED. This study describes the demographics and outcomes of a cohort presenting with conjunctivitis to a nationwide UCC system. Methods: This retrospective study included 17 branches of UCC. Electronic Medical Record data (November 2015–October 2016) of patients diagnosed with conjunctivitis or ocular disorder were retrieved. Data included gender, age, diagnosis, treatment, discharge status and temperature. Patients without conjunctivitis, presenting to UCC during this period served as the control. Results were compared to all ED patients in Israel (from a public report). Descriptive statistics, Chi-square and Z-proportion test were used. Results: Altogether, 602,074 patients presented to UCC, of which 5,045 (0.84%, 95% CI 0.74–0.94%) were diagnosed with conjunctivitis. Conjunctivitis was more prevalent among young males (0–14, p <0.001) and older females. The conjunctivitis cohort at UCC was significantly younger than the ED cohort ( p <0.01). UCC treated and released home 96.7% (95% CI 96.2–97.2%) of cases. This is significantly higher than the treatment rate for the entire UCC cohort (93.2%, CI 93.2–93.3%, p <0.05). Treatment in most cases (82.0%, 95% CI 80.9–83.0%) involved the prescription of ocular antibiotic. Conclusion: Similar to previous studies at ED, conjunctivitis patients are primarily young males. Most patients were treated with antibiotics at UCC and released home. This suggests that UCC may be a good venue for treatment of conjunctivitis.

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Nursery sickness policies and their influence on prescribing for conjunctivitis: audit and questionnaire survey

Cited by 9 publications

References 19 publications

Use of topical ocular antibiotics in young children: a Scandinavian drug utilization study

Use of topical ocular antibiotics in young children: a Scandinavian drug utilization study

Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis

<p>The epidemiology and treatment of conjunctivitis at Urgent Care Centres in Israel</p>

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