General practitioner consultations for respiratory tract infections in children under 5 years; retrospective cohort study 2016-2023.

Background: Little is known about how GP consultation rates for children's respiratory tract infections (RTIs) have changed since the covid-19 pandemic restrictions lifted.

Aim: To describe changes in GP consultation rates for RTIs in children <5 years from 2016-2023.

Design And Setting: Population-based retrospective cohort study using electronic health records.

Methods: We included all children aged <5 years registered with a general practice from April 2016 to March 2023. We compared monthly GP consultation rates for RTIs from April 2021-March 2023 with corresponding months during pre-pandemic years (April 2016-February 2020).

Results: There were 3 045 701 GP consultations for RTIs among 2 894 539 children. Pre-pandemic, monthly consultation rates ranged from lows in August to highs in November (from 2368 to 8682 per 100 000 children, respectively). Following the pandemic lockdowns in 2020, monthly rates in 2021/22 peaked in June and October, but the winter peak was less marked than pre-pandemic and mean monthly rates were 16.8% lower. In 2022/23 after all restrictions lifted, rates remained around 15% below pre-pandemic years, but the winter peak for children aged 3-4 exceeded prior winter peaks by 43.3% and coincided with a streptococcal group A outbreak. Across all ages, there was a sharp increase (around 60%) in tonsillitis, streptococcus A and bacterial ear infections.

Conclusion: Our study shows reductions in GP consultations for RTIs for children under 5 since the lifting of covid-19 pandemic restrictions. Of concern is a sharp rise in tonsillitis, streptococcus A and bacterial ear infections that should be monitored.