Antibiotics for acutely ill children and the impact of COVID-19 on prescribing in ambulatory care

Physicians' diagnostic uncertainty regarding acutely ill children, combined with parent's worries and expectations, leads to inappropriate antibiotic prescribing and, consequently, antimicrobial resistance. First of all, an evaluation of antibiotic prescribing practices in Belgium and other high-income countries must be updated. Therefore, we will analyse data from a national prescription database (Farmanet). Moreover, a systematic review will be perfomed to assess the rate of antibiotic prescriptions and their appropriateness worldwide. Secondly, we aim to impact physicians' long-term prescribing behaviour by targeting them by different strategies (i.e. clinical decision tree, CRP POCT, and safety netting advice) as part of an algorithm. When deemed to be clinical and economic efficacous, this algorithm must be implemented in the out-of-hospital setting. Hence, we will perform a process-evaluation and an implementation project on this algorithm by means of qualitative semi-structured interviews. We aim to implement this innovative tool to support clinical decision making in order to help tackle antimicrobial resistance and educate (future) physicians to encourage appropriate antibiotic prescribing behaviour.