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Differences in antibiotic prescribing patterns for children younger than five years in the three major outpatient
Natasha B Halasa1, Marie R Griffin, Yuwei Zhu
1Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA.
Insights
Antibiotic prescribing for young children declined between 1994-2000, particularly in office-based and emergency department settings. This trend indicates a positive shift in antibiotic stewardship for pediatric outpatient care.
Area of Science:
- Pediatric infectious disease
- Antimicrobial stewardship
- Public health surveillance
Background:
- Antibiotic overuse is a significant public health concern, contributing to antimicrobial resistance.
- Understanding prescribing patterns in different outpatient settings is crucial for targeted interventions.
Purpose of the Study:
- To analyze antibiotic utilization across three major outpatient settings: office-based clinics, emergency departments (ED), and hospital-based clinics.
- To examine trends in antibiotic prescribing for children under 5 years of age from 1994 to 2000.
Main Methods:
- Utilized data from the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS).
- Analyzed visit rates and antibiotic prescribing patterns for children <5 years of age.
- Compared prescribing practices across office-based clinics, EDs, and hospital-based clinics.
Main Results:
- Overall antibiotic prescription rates decreased from 1405 to 1088 per 1000 children.
- Significant declines were observed in office-based settings (1119 to 841) and EDs (237 to 198).
- Racial disparities in antibiotic receipt were noted, though prescribing rates became similar for white and black children later in the study period.
Conclusions:
- A notable decline in antibiotic prescribing for children under 5 years old occurred.
- This decline was most pronounced in office-based and emergency department settings.
- Findings highlight evolving antibiotic stewardship practices in pediatric outpatient care.
Objectives:
To perform a comprehensive analysis of the use of antibiotics in three major sites for outpatient care: private office-based clinics, emergency departments (ED), and hospital-based clinics.
Study Design:
Data from the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) were used to determine visit rates and antibiotic prescribing patterns for the three major outpatient care settings from 1994 to 2000 for children <5 years of age.
Results:
Antibiotic prescription rates declined from 1405 to 1088 per 1000 children over the study years (P=.032) [correction]. Significant declines in antibiotic prescriptions were noted in both the office-based setting and ED: 1119 to 841 (P=.049) in the office-based setting and 237 to 198 antibiotic prescriptions per 1000 children in the ED (P=.003) [correction]. Sites of care differed markedly with white children receiving 82.5%, 14.3%, and 3.2% of antibiotics in the office-based settings, ED, and hospital-based clinics, respectively, compared with 60%, 31%, and 9% for black children (P<.001). However, total visits, visits resulting in a diagnosis of otitis media, and antibiotic prescribing rates were similar for white and black children during the latter study years.
Conclusions:
There has been a decline in antibiotic prescribing in children <5 years of age, which was most notable in office-based and emergency department settings.
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