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Respiratory tract infections among children younger than 5 years: current management in Australian general practice

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Acute respiratory tract infections (RTIs) are managed at more than 6 million general practice visits each year in Australia.1 RTIs such as the common cold (acute upper respiratory tract infection [URTI]), acute bronchitis/bronchiolitis, acute tonsillitis and pneumonia create a severe health and economic burden.1 They are most prevalent among young children, especially when they attend preschools or day care centres. It is estimated that children younger than 5 years have a cold 23% of the time,2 with 70% of the costs attributed to carers’ lost time at work.3

Current guidelines on the treatment and management of RTIs in children include supportive management such as hydration and rest.4 Over-the-counter (OTC) medications such as analgesics and cough medications may reduce the severity of symptoms, but they do not cure or prevent the illness.

As most RTIs are caused by viruses, antibiotics have limited therapeutic value and should only be prescribed if an RTI is suspected to be bacterial in origin. However, overseas studies suggest high rates of antibiotic prescribing for RTIs among young children.5,6 Contributing factors include physicians’ diagnostic uncertainty, parents’ expectation…