Study: Antibiotic use among U.S. children reduced
The overuse of antibiotics in children may be subsiding, according to a study published in the September issue of Pediatrics.
Organizations such as the Centers for Disease Control and Prevention in Atlanta have promoted the message that overuse of the drugs can lead to antibiotic resistance. The researchers wanted to see if physicians were heeding the message. The researchers looked at the rate of antibiotic prescribing from 1996-2000 in nine U.S. health plans, at patterns of diagnosis and treatment responsible for these trends, and at changes in the use of first-line antimicrobial agents. They focused on patterns of antibiotic use among infants and children younger than 3 years of age in whom the rates of antibiotic use are highest.
To begin their study, the researchers gathered data from each of the health plans on 25,000 children, ages 3 months to 18 years, who were enrolled between Sept. 1, 1995, and Aug. 31, 2000. Antibiotic dispensings were linked with an ambulatory visit claim to assign diagnosis.
Antibiotic dispensings per person-year were calculated for three age groups: 3 months to 3 years, 3 years to 6 years, and 6 years to 18 years. The researchers found that from 1996 to 2000, antibiotic rates for children ages 3 months to 3 years decreased 24%. The rates also decreased 25% for children ages 3 years to 6 years and 16% for children 6 years to 18 years. The reduction varied among health plans from 6% to 39% for children ages 3 months to 3 years.
A decrease in prescriptions for otitis media accounted for 59% of the total decrease, and was primarily accounted for by a decrease in the rate of diagnosis of this condition. The proportion of first-line penicillins increased from 49% to 53%, with health plans with the lowest initial rates increasing most.
The researchers say that the substantial decrease in antibiotic prescribing is likely a reflection of increased patient and clinician awareness of antibiotic overuse and resistance from other sources.
If this trend continues, it will be critical to monitor changes in patterns of resistance of common pathogens such as S. pneumoniae in the community to gauge the benefit of decreased prescribing, the researchers add. "Conversely," they continue, "it will be critical to carefully monitor rates of mastoiditis and other rare complications of common bacterial infections as clinicians and parents raise their thresholds for using antibiotics. Such ongoing assessment will allow a more fully informed consideration of the risks and benefits of antibiotic use by children in an era of increasing resistance."
The overuse of antibiotics in children may be subsiding, according to a study published in the September issue of Pediatrics.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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