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Table 4 Treatment recommendation

From: Understanding the influence of parent-clinician communication on antibiotic prescribing for children with respiratory tract infections in primary care: a qualitative observational study using a conversation analysis approach

Treatment recommendation

Frequency (%)

Verbatim Example

Home care advice only

31 (55%)

I think let’s see how he goes” (C220: NP)

“lots of rest, lots of fluid. Calpol [child paracetamol] if he needs it … Make sure he eats and drinks plenty. He can probably go to school now” (C214: GP)

Antibiotics (immediate)

8 (14%)

“Well, she seems really well. … But, because I can hear that little noise in her chest, I’m going to give her some antibiotics because it sounds like there’s a little infection in there.” (C219: NP)

I think if the phlegm was yellowy, it’s probably worth using an antibiotic” (C213: GP)

I think he has an infection in his ear. And that might be why he’s getting the temperatures and being sick. … I think that will improve with the antibiotics for his ear.” (C205: GP)

Antibiotics (delayed)

4 (7%)

by Monday, if she’s still having temperatures, even if she gets no more unwell in herself, then that’s gone on longer than I would expect with a viral thing, and I would want her to have antibiotics at that point.” (C205: GP)

“his right ear drum is a lot more swollen and red that the left okay, which I think is where the infection’s stemming from … I wouldn’t give him antibiotics at the moment but I will give you the prescription … by tomorrow it will be more than 3 days, I would hope that … his temperature has started to come down. If not, start the antibiotics.” (C203: GP)

Steroids only

10 (18%)

His lungs at the bottom … are slightly [wheezy] sounding, which is normally what we hear with a viral chest infection … I’m not really sure that he’s going to benefit … on antibiotics, but he might benefit from a little bit of inhaler, just to try and loosen the chest slightly.” (C207: GP)

OTC prescribed

3 (5%)

Mother: “could I possibly have a prescription for Calpol?

GP: Yeah, no problem. (C201: GP)

Mother: Is that alright? Just ‘cos … I haven’t brought my wallet with me this – you know.” (P11: mother)