Antimicrobial prescribing for children in primary care

Area of Science:

• Paediatric Pharmacology
• General Practice Research
• Antimicrobial Stewardship

Background:

• Antimicrobial prescribing in children is a significant public health concern.
• Understanding prescribing patterns in general practice is crucial for effective antimicrobial stewardship.
• Previous studies have highlighted variations in antibiotic use among different demographics and settings.

Purpose of the Study:

• To characterize antimicrobial prescribing trends in Australian general practice for paediatric patients (≤18 years).
• To identify common antibiotics prescribed, reasons for prescription, and variations in prescribing practices.
• To analyze prescribing data over a five-year period to observe changes and identify areas for improvement.

Main Methods:

• Retrospective review of routinely collected patient data from 39 general practices in eastern metropolitan Melbourne.
• Data spanned a 5-year period (2010-2014), encompassing 744,883 consultations for 89,983 paediatric patients.
• Analysis focused on the proportion of consultations resulting in antibiotic prescriptions, types of antibiotics, and inter-practice variations.

Main Results:

• Approximately one in five children received an antibiotic prescription annually.
• Cephalexin, amoxicillin/clavulanate, and cefaclor were the most frequently prescribed antibiotics.
• Significant inter-practice variation in prescribing frequency (2.1-19.7%) was observed, with an overall 2.3% decrease in prescribing over the study period.

Conclusions:

• The study highlights specific antibiotic prescribing practices for children in Australian general practice.
• Further investigation is needed into the low use of amoxicillin and continued use of cefaclor.
• Findings underscore the need for targeted interventions to optimize paediatric antibiotic prescribing.