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Individual maternal and child exposure to antibiotics in hospital - a national population-based validation study
C Almqvist1, A K Örtqvist, T Gong
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Lung and Allergy Unit, Karolinska University Hospital, Stockholm, Sweden.
Insights
Early life antibiotic exposure is linked to future health. This study quantises antibiotic use in Swedish hospitals for pregnant women and children up to five years old, correlating diagnoses with prescriptions.
Area of Science:
- Pediatric Health
- Infectious Disease Management
- Pharmacovigilance
Background:
- Antibiotic exposure in early life is a growing concern for long-term health.
- While outpatient antibiotic use is common, inpatient exposure, especially in vulnerable populations, requires detailed investigation.
- Understanding the link between specific hospital diagnoses and antibiotic prescriptions is crucial for public health.
Purpose of the Study:
- To quantify individual antibiotic exposure in relation to specific inpatient diagnoses among pregnant women and children (birth to 5 years) in Sweden.
- To establish a baseline for antibiotic prescribing patterns in a key demographic for future research.
- To inform strategies for optimizing antibiotic stewardship in pediatric and maternal inpatient settings.
Main Methods:
- Retrospective analysis of inpatient data from the Swedish National Patient Register (July 2005 - November 2011).
- Inclusion of pregnant women and children (birth to 5 years) with infectious and common inpatient diagnoses.
- Manual review of medical records from a random sample of individuals to determine antibiotic prescriptions linked to diagnoses.
Main Results:
- Antibiotic treatment was observed in 25% of premature infants.
- Children aged 1-5 with bacterial infections received antibiotics more frequently (62.4-90.6%) than those with viral infections (6.3-22.2%).
- Women undergoing Cesarean sections had higher antibiotic use (40.1%) compared to vaginal deliveries (11.1%).
Conclusions:
- This study provides the first detailed quantification of antibiotic treatment for specific inpatient diagnoses in Swedish mothers and young children.
- The findings establish a critical baseline for antibiotic use in this population.
- This data is essential for future research on the long-term health impacts of early-life antibiotic exposure and for refining antibiotic stewardship programs.
Aim:
Exposure to antibiotics in early life may affect future health. Most antibiotics are prescribed in outpatient care, but inpatient exposure is also important. We estimated how specific diagnoses in hospitals corresponded to individual antibiotic exposure.
Methods:
All pregnant women and children from birth to 5 years of age with infectious diseases and common inpatient diagnoses between July 2005 and November 2011 were identified from the Swedish National Patient Register. Random samples of individuals from predefined groups were drawn, and medical records received from the clinics were manually reviewed for antibiotics.
Results:
Medical records for 4319 hospital visits were requested and 3797 (88%) were received. A quarter (25%) of children diagnosed as premature had received antibiotics, and in children from one to 5 years of age, diagnoses associated with bacterial infections were more commonly treated with antibiotics (62.4-90.6%) than those associated with viruses (6.3-22.2%). Pregnant women who had undergone a Caesarean section were more likely to be treated with antibiotics than those who had had a vaginal delivery (40.1% versus 11.1%).
Conclusion:
This study defines the proportion of new mothers and young children who received individual antibiotic treatment for specific inpatient diagnoses in Sweden and provides a useful basis for future studies focusing on antibiotic use.
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