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A prospective study of antibiotic use and associated infections in young children
G R Bergus1, S M Levy, H L Kirchner
1Department of Family Medicine, The Colleges of Medicine and Dentistry, University of Iowa, Iowa City 52242, USA. george-bergus@uiowa.edu
Insights
Antibiotic use is common in young children, increasing with age. Otitis media was the primary reason for antibiotic prescriptions, with most children receiving treatment by 20 months.
Area of Science:
- Pediatric infectious diseases
- Pharmacology and therapeutics
- Public health epidemiology
Background:
- Antibiotic resistance is a growing global concern.
- Understanding early-life antibiotic exposure is crucial for child health.
- Data on antibiotic use patterns in infants and young children are limited.
Purpose of the Study:
- To investigate the incidence and patterns of antibiotic usage in a cohort of infants and young children.
- To identify common indications for antibiotic prescriptions in early childhood.
- To examine factors associated with antibiotic exposure, such as age and sex.
Main Methods:
- Longitudinal cohort study involving 1,368 children recruited at birth from eight hospitals in eastern Iowa.
- Parental questionnaires administered at multiple time points from 6 weeks to 20 months of age.
- Kaplan-Meier survival analysis used to determine cumulative incidence of antibiotic use and infections.
Main Results:
- Antibiotic use was prevalent, increasing with age, with approximately 50% exposed by 3 months.
- Otitis media accounted for 67.3% of antibiotic prescriptions.
- By 20 months, 92.5% of children had received at least one course of antibiotics, with a median of 43 days of treatment.
- Males showed a higher likelihood of antibiotic exposure compared to females.
Conclusions:
- Antibiotic exposure is widespread in early childhood, often for otitis media.
- Long-term antibiotic use in young children warrants further investigation.
- Monitoring antibiotic prescribing practices is essential to mitigate potential risks like antibiotic resistance.
Abstract:
This study examines antibiotic usage and associated infections in infants and young children in Iowa. Longitudinal data were collected using a cohort recruited at birth from eight hospitals in eastern Iowa. Parents of recruited children were mailed questionnaires at 6 weeks, and 3, 6, 9, 12, 16, and 20 months of age. The cumulative incidence of antibiotic use and associated infections was determined using Kaplan-Meier survival analysis. There were data on 1,368 children. Antibiotic use was common in our cohort and increased with age. Beginning at age 3 months, approximately 50% of the cohort was exposed to an antibiotic during each reporting period. Otitis media was the most common indication and was responsible for 67.3% of antibiotic use. Children were most frequently treated with amoxicillin, followed by the cephalosporins and sulphonamides. By 12 and 20 months of age 79.0% and 92.5% of the children, respectively, had been treated with at least one course of antibiotics. Children received antibiotics for a median of 43 days by 20 months of age. Males were more likely to experience any antibiotic exposure than females (hazard ratio = 1.18) and showed a trend for more days of use (P = 0.052). There was a small but significant variation in antibiotic usage in the different recruitment communities (P = 0.02).