What this study adds
respiratory tract infection, PD
RESPIRATORY TRACT INFECTION
The multifaceted intervention investigated included eliciting parental concerns, an algorithm to identify children at very low risk of hospital admission, and safety netting advice for carersThe intervention, designed for pre-pandemic conditions, did not reduce overall antibiotic dispensing or increase respiratory tract infection related hospital admissionsSubgroup and sensitivity analyses suggested that the intervention may be effective for older children and practices with fewer prescribing nurses, on a single site, or located in less deprived areasThis study was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration, part of the Bristol Trials Centre, which receives National Institute for Health and Care Research (NIHR) clinical trials unit support funding. The University of Bristol is acting as the sponsor for this trial, and the trial is hosted by the NHS Bristol, North Somerset, and South Gloucestershire Clinical Commissioning Group (CCG). We thank all general practices, clinical commissioning groups, and clinical research networks for their involvement in CHICO. We also to thank the members of the Trial Steering Committee and Data Monitoring Committee.Extra material supplied by authorsWeb appendix: Supplementary materialsContributors: AH, PSB, PJL, NAF, and JI were responsible for developing the research questions. PSB, AH, JI, PJL, CCabral, CClement, EB, MG, JH, SC, JAL, and NAF were responsible for the study design and collection of data. PS, SB, and JT were responsible for study management and coordination. GY, PD, and CClement were responsible for the analysis of the data. PB drafted the paper and is the guarantor. All authors read, commented on, and approved the final manuscript. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.Funding: This research is funded by the NIHR Health Technology Assessment programme (funder ref: 16/31/98, ISRCTN11405239). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. The funders had no role in considering the study design or in the collection, analysis, and interpretation of data, the writing of the report, or the decision to submit the article for publication.Competing interests: All authors have completed the ICMJE uniform disclosure form at The lead author affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as originally planned (and, if relevant, registered) have been explained.Dissemination to participants and related patient and public communities: Patients and clinicians were involved in the design, conduct, reporting, and dissemination plans of this research. Refer to the Methods section for further details. Participants will be contacted with a summary of the findings when the embargo for the published main findings is lifted.Provenance and peer review: Not commissioned; externally peer reviewed.