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Updated: Aug 29, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Trends in prescribing antibiotics for children in Dutch general practice

Hanneke B M Otters1, Johannes C van der Wouden, Francois G Schellevis

  • 1Department of General Practice, Ff305, P.O. Box 1738, Erasmus MC, University Medical Center Rotterdam, 3000 DR Rotterdam. j.otters@erasmusmc.nl

The Journal of Antimicrobial Chemotherapy
|January 20, 2004
PubMed

Insights

Antibiotic prescribing for children in the Netherlands decreased overall, but the use of broad-spectrum antibiotics for inappropriate conditions increased. Targeted interventions for single-handed practices are recommended to improve antibiotic stewardship.

Area of Science:

  • Pediatric infectious disease
  • Antimicrobial stewardship
  • General practice epidemiology

Background:

  • Antibiotic prescribing patterns in children are crucial for combating antimicrobial resistance.
  • Understanding trends in pediatric antibiotic use and associated practice characteristics is essential.
  • The Netherlands has historically shown relatively low antibiotic prescribing rates in children.

Purpose of the Study:

  • To evaluate changes in antibiotic prescribing patterns for pediatric patients in Dutch general practice between 1987 and 2001.
  • To identify general practice characteristics linked to elevated antibiotic prescribing rates.
  • To assess the appropriateness of antibiotic selection for common childhood infections.

Main Methods:

  • A cross-sectional national survey of Dutch general practices was conducted in 1987 and 2001.
  • Data included 86,577 children (0-17 years) in 103 practices (1987) and 76,010 children in 90 practices (2001).
  • Prescription rates (population-based, contact-based, disease-based) were analyzed by age, gender, and diagnosis, with a focus on broad-spectrum antibiotic use and practice factors.

Main Results:

  • Population-based antibiotic prescription rates declined from 300/1000 children in 1987 to 232/1000 in 2001.
  • Contact-based prescription rates remained stable (108/1000 contacts in 1987 vs. 103/1000 in 2001).
  • Prescription rates for specific conditions like acute otitis media and upper airway infections increased, with a rise in non-recommended broad-spectrum antibiotic use from 87% to 90% (P < 0.001). Single-handed practices inappropriately prescribed 58% more broad-spectrum antibiotics for upper airway infections compared to group practices.

Conclusions:

  • While overall antibiotic prescribing for children in the Netherlands remains relatively low, there is a concerning increase in broad-spectrum antibiotic use for inappropriate indications.
  • This trend is unfavorable due to the growing threat of bacterial resistance.
  • Interventions targeting single-handed general practices are recommended to optimize antibiotic prescribing in pediatric care.
Abstract

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