{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:37:36Z","timestamp":1761514656906,"version":"3.37.3"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["DRF\u20102014\u201007\u2010005"],"award-info":[{"award-number":["DRF\u20102014\u201007\u2010005"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Children with Down syndrome (DS) are at high risk of respiratory tract infections (RTIs) due to anatomical variations, comorbidities, and immune system immaturity. Evidence on interventions to reduce this risk is incomplete. This study aims to quantify the effect of antibiotics prescribed for RTIs in primary care on the subsequent risk of RTI\u2010related hospitalization for children with DS versus controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study of 992 children with DS and 4874 controls managed by UK National Health Service General Practitioners (GPs) and hospitals as identified in CALIBER (Clinical disease research using LInked Bespoke studies and Electronic health Records), 1997\u20132010. Univariate and multivariate logistic regression were undertaken.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In children with DS, the prescription of antibiotics following an RTI\u2010related GP consultation did not significantly reduce the risk of RTI\u2010related hospitalization in the subsequent 28 days (risk with antibiotics, 1.8%; without, 2.5%; risk ratio, 0.699; 95% confidence interval, 0.471\u20131.036). Subgroup analyses showed a risk reduction only in infants with DS, after adjustment for covariates. There was no reduction in risk for controls, overall or across subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In conclusion, while prescription of antibiotics following RTI\u2010related GP consultations were effective for infants with DS in reducing subsequent RTI\u2010related hospitalization, this was not the case for older children with DS. We would encourage further high\u2010quality cohort and randomized controlled trials to interrogate this finding, and to examine the impact of antibiotics on other endpoints, including symptom duration.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.25100","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T19:04:59Z","timestamp":1601492699000},"page":"171-178","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of antibiotics in preventing hospitalizations from respiratory tract infections in children with Down syndrome"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5288-3325","authenticated-orcid":false,"given":"Logan","family":"Manikam","sequence":"first","affiliation":[{"name":"UCL Institute of Epidemiology and Health Care University College London  London UK"},{"name":"UCL Institute of Health Informatics Research University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Lakhanpaul","sequence":"additional","affiliation":[{"name":"Population, Policy &amp; Practice, UCL Great Ormond Street Institute of Child Health University College London  London UK"},{"name":"Whittington Health NHS Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne G. 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