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Decrease in antibiotic use among children in the 1990s: not all antibiotics, not all children.

Anita L Kozyrskyj1, Anita G Carrie, Garey B Mazowita

  • 1Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg. kozyrsk@cc.umanitoba.ca

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
|July 21, 2004
PubMed
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Antibiotic prescriptions for children decreased overall, but broader-spectrum macrolide use rose significantly. Higher rates persisted among preschoolers and low-income children, potentially impacting antibiotic resistance.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Antibiotic use trends in children were examined from fiscal year (FY) 1995 to FY 2001 in Manitoba.
  • Previous reports indicated widespread decreases in antibiotic use during the 1990s.

Purpose of the Study:

  • To determine trends in antibiotic prescription rates among a complete population of Manitoba children.
  • To analyze antibiotic use patterns by class, age, diagnosis, and socioeconomic status.

Main Methods:

  • Population-based antibiotic prescription rates were calculated using Manitoba health care databases.
  • Analysis included antibiotic class (narrow- vs. broad-spectrum), age group, physician diagnosis, and neighborhood income.
  • Generalized linear models with generalized estimating equations were used to assess trends and differences over time.

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Main Results:

  • Overall antibiotic prescriptions per child decreased by nearly one-third from FY 1995 to FY 2001.
  • Significant declines were observed for sulfonamides and narrow-spectrum macrolides.
  • Broader-spectrum macrolide use increased up to 12.5-fold, particularly for otitis media in preschoolers and low-income children.

Conclusions:

  • While overall antibiotic use declined, the rise in broader-spectrum macrolides is a concern.
  • Preschool-aged and low-income children exhibited higher antibiotic prescription rates.
  • These trends may have significant implications for the development of antibiotic resistance.