Worried parents 

Understandably, parents are often more worried about an infection in a child than if they themselves had the infection. A useful resource is ‘When Should I Worry’, which can be downloaded or viewed online. Booklets translated into many languages are available if catering for an ethnically diverse local population. 

The booklet has been used in research in a GP setting and resulted in a two-thirds reduction in antibiotic prescribing, a reduced intention to consult in future and did not impact on parental satisfaction.

The website includes free training on the use of the booklet, which can be used by parents and retained in case of further infections in their children (which, of course, are inevitable). It also provides guidance on severe symptoms that may require urgent medical attention. 

‘When Should I Worry’ discusses fever and explains to parents that “fever does not harm your child” and advises that lowering temperature is not necessary. The resource concludes with this summary: 

• Most common infections do not get better quicker with antibiotics
• Most children with a cold, cough, sore throat or earache, who see their GP, will still be ill four days later. This does not mean that they need treatment or that they have to be seen again 
• One-third of children who have seen their GP with a cough will still be coughing two weeks later. This does not mean that they need treatment
• Only children with signs of more serious illness generally need to be seen by a doctor.

These signs can include: 

• Excessive drowsiness
• Difficulty breathing or rapid breathing
• Cold or discoloured hands and/or feet with warm body
• Abnormal pains in arms and/or legs
• Abnormal colour (pale or blue).

The packaging for paracetamol and ibuprofen OTC preparations often tells parents not to use them for more than a couple of days without seeing a doctor. If the child does not have any of the features listed above and the parent is not overly worried about them, they can continue to use these products for longer – given your approval – as long as safety-netting has been clearly explained.

The TARGET Antibiotic Counselling Sheet provides a summary for each antibiotic of common side-effects, major drug interactions and use in pregnancy/breastfeeding.