Clinical algorithm reduces antibiotic use among children presenting with respiratory symptoms to hospital in central Vietnam

Table 4 Management of children presenting to the respiratory outpatient clinic with respiratory symptoms according to algorithm classification, before and after the intervention

Classification*	Before N = 1290	After N = 166	p-value
Group 1^a
Number	22	6	-
Admitted to hospital	6 (27.3)	1 (16.7)	-
Discharged with antibiotic	13 (59.1)	4 (66.6)	0.1
Discharged without antibiotic	3 (13.6)	1 (16.7)
Group 2^b
Number	355	118	-
Admitted to hospital	14 (3.9)	2 (1.7)	-
Discharged with antibiotic	166 (46.7)	34 (28.8)	< 0.0001
Discharged without antibiotic	175 (49.4)	82 (69.5)
Group 3^c
Number	913	42	-
Admitted to hospital	82 (8.9)	11 (26.2)	-
Discharged with antibiotic	383 (41.9)	18 (42.9)	0.2
Discharged without antibiotic	448 (49.2)	13 (30.9)

^*Classified according to groups described in Fig. 1 from retrospective data analysis
^aChildren with any WHO danger sign or SpO2 < 90% OR consolidation on CXR or ANC ≥ 10 × 10⁹/L (or CRP ≥ 50 mg/L). Suggested management: admit to the hospital and provide antibiotics
^bChildren with wheeze/runny nose and no fever OR No consolidation on CXR and ANC < 5 × 10⁹/L (or CRP < 10 mg/L). Suggested management: no hospital admission and no antibiotics
^cChildren not belonging to groups 1 or 2. Suggested management: consider not to admit and consider oral antibiotics
ANC absolute neutrophil count, CXR chest radiograph, FBC full blood count, CRP C reactive protein, SpO2 peripheral oxygen saturation, WHO World Health Organization

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