Does application of the Feverkidstool reduce antibiotic prescritions for children with respiratory infections?

BEEM Bottom Line

Why is this study important?

Although most lower respiratory tract infections (RTIs) are caused by viruses, children with RTI symptoms are commonly prescribed antibiotics in the emergency department (ED).[1]  The Feverkidstool is a validated clinical decision rule that calculates the risk of serious bacterial infections in children based on the following predictors: age (years); sex; respiratory rate; temperature (oC); heart rate; fever duration (days); C-reactive protein (CRP; mg/l); capillary refill (< 2 seconds [sec]; 2–4 sec; > 4 sec); chest wall retractions; ill appearance; and oxygen (O2) saturation (< 94%).[2] This trial assessed whether application of this tool in the ED would reduce antibiotic prescribing for children identified as low (< 3%) or intermediate risk (4–10%) of bacterial pneumonia.

Which, if any, threats to validity are most likely to have an impact on the results and how?

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