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Use of antibiotics in children: a Danish nationwide drug utilization study
Anton Pottegård1, Anne Broe, Rune Aabenhus
1From the *Clinical Pharmacology, Department of Public Health, University of Southern Denmark; †Department of Clinical Chemistry and Pharmacology, Odense University Hospital; and ‡Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Insights
Antibiotic prescribing for children in Denmark remained high and stable from 2000-2012. While broad-spectrum penicillin use increased, antibiotic choices generally followed national guidelines.
Area of Science:
- Pediatric pharmacology
- Public health surveillance
- Infectious disease epidemiology
Background:
- Systemic antibiotic use in pediatric populations is a significant public health concern.
- Understanding national prescribing patterns is crucial for antimicrobial stewardship.
Purpose of the Study:
- To describe the utilization of systemic antibiotics in children in Denmark.
- To analyze trends and patterns in pediatric antibiotic prescriptions over a 13-year period.
Main Methods:
- Utilized national prescription data from the Danish National Prescription Database.
- Included all children aged 0-11 years in Denmark from January 1, 2000, to December 31, 2012.
Main Results:
- Over 5.8 million antibiotic prescriptions were issued to over 1.2 million children.
- Phenoxymethylpenicillin (45%) and amoxicillin (34%) were the most prescribed antibiotics.
- Highest incidence rates were in children under 2 years old, with a shift towards broader-spectrum amoxicillin in younger children.
Conclusions:
- Pediatric antibiotic prescribing rates in Denmark remained consistently high between 2000 and 2012.
- An increase in broad-spectrum beta-lactam penicillin use was observed.
- Prescribing patterns largely aligned with national guidelines regarding antibiotic selection.
Background:
We aimed to describe the use of systemic antibiotics among children in Denmark.
Methods:
National data on drug use in Denmark were extracted from the Danish National Prescription Database. We used prescription data for all children in Denmark aged 0 to 11 years from January 1, 2000 to December 31, 2012.
Results:
We obtained data on 5,884,301 prescriptions for systemic antibiotics issued to 1,206,107 children. The most used single substances were phenoxymethylpenicillin (45%), amoxicillin (34%) and erythromycin (6%). The highest incidence rate of antibiotic treatment episodes was observed among children younger than 2 at 827 per 1000 children in 2012. Incidence rates were relatively stable throughout the study period. One-year prevalences in 2012 were 485, 363 and 190 per 1000 children among children aged 0-1, 2-4 and 5-11, respectively. A gradual shift from narrow-spectrum penicillin V to the broader-spectrum amoxicillin was found among children younger than 5. The use of macrolides decreased slightly, especially among those aged 0-1. Minor regional differences were noted, with somewhat higher use in the Capital Region. Skewness in use was most notable among those aged 0-1. There was little evidence of heavy users.
Conclusion:
Prescribing rate of antibiotics to children in Denmark remained stable at a high level from 2000 to 2012. An increase in the use of broad-spectrum beta-lactam penicillin was noted, but otherwise the prescribing pattern adhered well to National guidelines with respect to choice of antibiotics.
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