For most children flu or a flu like illness (FLI) is a mild and short illness, but is considered to be a factor for secondary complications, including bacterial infections. Children who have an underlying health condition (Diabetes, Down syndrome etc.) are particularly vulnerable to developing secondary complications. Flu and FLI in these children place a great burden on families and healthcare systems.

We conducted a clinical trial to see if giving children an antibiotic (co-amoxiclav) early on in their illness would help them feel better more quickly and prevent complications. We conducted a sub study to take follow up throat swabs at three times for a year to check for any signs of antibiotic resistance from co-amoxiclav treatment. We explored the cost effectiveness of treatment with co-amoxiclav and if it was possible to identify which children would benefit most from it.

What we found:

• The clinical trial indicated there was no evidence of difference between children given co-amoxiclav and those given a placebo.
• The swab sub study indicated that the treatment with co-amoxiclav did not cause children we recruited to develop long lasting resistance to antibiotics.
• We found a trend towards lower overall healthcare costs associated with the co-amoxiclav group in the trial but a bigger trial would be needed to confirm this.
• It was not possible to identify if any specific group of children would benefit more from co-amoxiclav treatment early on in their illness.

This study is funded by the National Institute for Health Research (NIHR) Prorgramme Grants for Applied Research (RP/PG/1210/12012]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.