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Factors Associated with Prescribing Broad-Spectrum Antibiotics for Children with Upper Respiratory Tract Infections
Mohammad S Alzahrani1, Mary K Maneno1, Monika N Daftary1
1Department of Clinical and Administrative Pharmacy Sciences, Howard University, Washington, DC, USA.
Insights
Broad-spectrum antibiotic prescribing is common for children with upper respiratory tract infections (URI). Factors like region and specific diagnoses are linked to increased use, highlighting a need for antibiotic stewardship.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Broad-spectrum antibiotic overuse in pediatric upper respiratory tract infections (URIs) contributes to antibiotic resistance.
- Identifying factors influencing prescribing patterns is crucial for developing targeted interventions.
Purpose of the Study:
- To determine factors associated with prescribing broad-spectrum antibiotics for children under 18 with URIs in outpatient settings.
Main Methods:
- Cross-sectional analysis of the National Ambulatory Medical Care Survey (NAMCS) and NHAMCS-OPD (2006-2010).
- Logistic regression models identified socio-demographic and clinical predictors of broad-spectrum antibiotic use.
- Stratified analysis by age group (<=2 vs >2 years) was performed.
Main Results:
- Broad-spectrum antibiotics were prescribed in 39% of estimated 6.8 million annual outpatient visits for pediatric URIs.
- Prescribing was higher in the South region compared to the West (OR=2.38).
- Diagnoses of acute sinusitis (OR=2.77) and acute otitis media (OR=1.90) were associated with increased broad-spectrum antibiotic use compared to acute pharyngitis.
Conclusions:
- Broad-spectrum antibiotic prescribing for pediatric URIs in ambulatory care is prevalent.
- Diagnosis and management strategies for URIs require focused awareness campaigns to promote judicious antibiotic use.
- Further research into regional variations and specific diagnostic associations can inform antibiotic stewardship efforts.
Objectives:
Broad-spectrum antibiotics are frequently prescribed for children with upper respiratory tract infections (URI). Excessive use of broad-spectrum antibiotics leads to the emergence of resistant bacteria. This study aimed to identify factors associated with prescribing broad-spectrum antibiotics among children younger than 18 years presenting with URI in outpatient settings.
Methods:
We conducted a cross-sectional analysis of the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey-Outpatient Departments (NHAMCS-OPD) between 2006 and 2010. Descriptive statistics of visits from children with URI were estimated. Simple and multiple logistic regression analyses were used to identify socio-demographic and clinical characteristics associated with broad-spectrum antibiotic prescribing. We also completed a stratified analysis by age (⩽2 vs >2).
Results:
A total of 4013 outpatient visits for children with URI from both NAMCS and NHAMCS-0PD data were examined. Broad-spectrum antibiotics were prescribed in 39% of the visits, accounting for an estimated 6.8 million visits annually. Multivariable analysis showed that visits in the South region (odds ratio [OR] = 2.38; 95% confidence interval [CI]: 1.38-4.10) compared with the West region and visits with diagnoses of acute sinusitis (OR = 2.77; 95% CI: 1.65-4.63) and acute otitis media (OR = 1.90; 95% CI: 1.32-2.74) compared with those with acute pharyngitis were associated with greater odds of broad-spectrum antibiotic prescribing.
Conclusions:
The prescribing of broad-spectrum antibiotics is common for children with URI in ambulatory care settings. Diagnosis and management of URI remain a critical area for awareness campaigns promoting judicious use of antibiotics.
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