Quality standard
Quality statement 1: Antibiotic use
Quality statement 1: Antibiotic use
Quality statement
Children with bronchiolitis are not prescribed antibiotics to treat the infection.
Rationale
Bronchiolitis is caused by a viral infection so antibiotics should not be used as treatment. The number of children who have bronchiolitis and who then develop a bacterial infection is extremely low. Antibiotics can lead to common adverse reactions. Reducing unnecessary antibiotics will help prevent the development of bacterial resistance and will also reduce costs.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local prescribing protocols to direct antibiotic prescribing in children with bronchiolitis.
Data source: Local data collection.
Process
a) Proportion of diagnoses of bronchiolitis with a prescription for antibiotics in primary care.
Numerator – the number in the denominator with a prescription for antibiotics.
Denominator – the number of diagnoses of acute bronchiolitis in primary care.
Data source: Local data collection.
b) Proportion of diagnoses of bronchiolitis with a prescription for antibiotics in secondary care.
Numerator – the number in the denominator with a prescription for antibiotics.
Denominator – the number of diagnoses of bronchiolitis in secondary care.
Data source: Local data collection.
What the quality statement means for different audiences
Service providers (such as primary and secondary care and emergency departments) ensure that protocols are in place to ensure that healthcare professionals do not prescribe antibiotics to treat bronchiolitis in children. Services also ensure that procedures are in place to monitor antibiotic prescriptions for bronchiolitis in children.
Healthcare professionals (GPs and secondary care clinicians) do not prescribe antibiotics to treat bronchiolitis in children.
Commissioners ensure that primary and secondary care services do not prescribe antibiotics to treat bronchiolitis in children.
Children with bronchiolitis are not given antibiotics to treat the condition because it is caused by a viral infection.
Source guidance
Bronchiolitis in children: diagnosis and management. NICE guideline NG9 (2015), recommendation 1.4.3 (key priority for implementation)