An effective, evidence-based, policy on antibiotic use in at-risk children during influenza season is needed to ensure that national antibiotic stockpiles are used in the most clinically appropriate and cost-effective way while adhering to responsible antimicrobial stewardship.
The ARCHIE programme (early use of Antibiotics for at-Risk CHildren with InfluEnza) consists of five inter-related work packages, shown in , and nine objectives. We present a summary of each work package that inform our conclusions and their implications.
Inter-relationship of work packages.
At the end of each work package summary is further detail on how it links to the others and how each work package contributed to the main implications of our work.
The management arrangements for the programme are detailed in Appendix 1.
Work package A: systematic review
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Objective 1: identify risk factors and assess the reliability of published prognostic models for influenza-related complications in children.
Work package B: qualitative work
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Objective 2: understand what factors influence GPs’ decisions about antibiotic prescribing for at-risk children with influenza/ILI.
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Objective 3: explore the experiences of parents of at-risk children who have previously become unwell owing to influenza/ILI and
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Objective 4: explore parental consulting attitudes in relation to influenza/ILI and involve parents of at-risk children in the development of trial materials.
Work package C: randomised controlled trial
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Objective 5: determine the effectiveness of early co-amoxiclav use in at-risk children with influenza/ILI.
Work package D: microbiology
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Objective 6 examine the impact on antibiotic resistance of early co-amoxiclav use in at-risk children with influenza/ILI.
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Objective 7 determine the impact on long-term respiratory bacterial carriage of early co-amoxiclav use in at-risk children with influenza/ILI.
Work package E: risk reduction scores and health economics
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Objective 8: develop and validate risk scores for influenza-related clinical deterioration and complications for use in children with influenza/ILI (work package E1).
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Objective 9: explore the cost-effectiveness of different potential strategies for early antibiotic use in at-risk children with influenza/ILI (work package E2).
