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Reduction in antibiotic use among US children, 1996-2000.
Jonathan A Finkelstein1, Christopher Stille, James Nordin
1HMO Research Network Centers for Education and Research on Therapeutics. Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts 02215, USA. jonathan_finkelstein@hphc.org
Pediatrics
|September 2, 2003
Summary
Antibiotic prescribing for children decreased significantly from 1996-2000, with fewer diagnoses of infections like otitis media. Public awareness campaigns likely encouraged more judicious antibiotic use.
Area of Science:
- Pediatric Health
- Antimicrobial Stewardship
- Public Health Interventions
Background:
- High rates of antibiotic prescribing in children fuel community antibiotic resistance.
- Public health organizations promote judicious antibiotic use in pediatric populations.
Purpose of the Study:
- Assess changes in pediatric antibiotic prescribing rates from 1996-2000.
- Identify diagnostic and treatment patterns influencing these trends.
- Evaluate shifts in first-line antimicrobial agent utilization.
Main Methods:
- Analysis of claims data for dispensed medications and physician visits across 9 US health plans.
- Calculation of antibiotic dispensings per person-year for children aged 3 months to 18 years.
- Utilized generalized linear mixed models to assess trends and site-specific differences.
Main Results:
- Overall antibiotic rates decreased by 16-25% across pediatric age groups.
- A 59% reduction in otitis media diagnoses significantly contributed to the decline in antibiotic prescriptions.
- The proportion of first-line penicillins increased from 49% to 53%.
Conclusions:
- Pediatric antibiotic prescribing declined significantly between 1996 and 2000.
- Decreased diagnosis of potential bacterial infections, particularly otitis media, paralleled this reduction.
- Public health attention to antibiotic resistance may have influenced diagnostic thresholds and led to more judicious prescribing.