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Published on: August 30, 2018
Secular trends of antibacterial prescribing in UK paediatric primary care
Verena Schneider-Lindner1, Caroline Quach, James A Hanley
1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
Insights
Antibacterial drug prescribing in UK children declined in the 1990s but has risen significantly since 2000. This trend affects all age groups and antibiotic types, highlighting a need for surveillance.
Area of Science:
- Pediatric infectious disease
- Antimicrobial stewardship
- Public health surveillance
Background:
- Antibacterial drug resistance necessitates judicious prescribing, particularly in pediatric populations.
- While UK antibacterial prescribing declined in the 1990s, recent trends require updated surveillance.
Purpose of the Study:
- To analyze antibiotic prescribing patterns and temporal trends in children aged 0-19 years in the UK over two decades (1993-2007).
Main Methods:
- Utilized the General Practice Research Database to identify pediatric antibiotic prescriptions from 1993 to 2007.
- Employed Poisson regression to model prescription rates, accounting for age, gender, calendar year, and practice variations.
Main Results:
- The study included over 1.75 million children and 5.8 million prescriptions.
- Prescription rates decreased until 2000, then increased by 40.7% by 2007, with annual increases of 4.3% post-2000.
- Broad-spectrum penicillins were most common, with their prescription rates rising 4.6% annually after 2000, mirroring trends across most antibacterial classes.
Conclusions:
- UK pediatric antibacterial prescribing has shown a consistent increase since 2000 across all demographics and drug classes.
- This sustained rise underscores the importance of ongoing monitoring and antimicrobial stewardship initiatives in pediatric care.
Background:
Resistance to antibacterial drugs can be contained by judicious prescribing. In particular, the use of these drugs in children requires ongoing surveillance. While there was a decline in antibacterial prescribing in the UK during the 1990s, recent trends are less well known.
Objectives:
To describe antibiotic prescribing patterns and time trends in children in the UK over the last two decades.
Methods:
We identified all children ages 0-19 years from 1993 to 2007 and their antibiotic prescriptions from the General Practice Research Database. We used Poisson regression to estimate prescription rates considering the children's age and gender, calendar year and practice.
Results:
The cohort included 1 751 645 children with 5 835 891 antibacterial prescriptions. The average prescription rate was 511 prescriptions per 1000 person-years [95% confidence interval (CI) 509-513]. As of 1995, the rate decreased to 419/1000 person-years (95% CI 411-426) in 2000, then increased to 568/1000 person-years (95% CI 559-577) in 2007. Between 2000 and 2007, rates increased on average by 4.3% (95% CI 3.7-5.0%) annually, amounting to an increase of 40.7% (95% CI 34.5-47.2%) for all children. Rates were generally higher in girls, except for boys <5 years. Broad-spectrum penicillins were most frequently prescribed; their rate increased on average by 4.6% annually (95% CI 4.0-5.3%) after 2000. This trend was similar in most classes of antibacterials.
Conclusions:
Antibacterial prescribing to outpatient children in the UK has been steadily increasing since 2000, consistently for boys and girls, across all ages and antibacterial classes.
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