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Increasing paediatric prescribing rates in British Columbian children: cause for concern?

Ariana Saatchi1, Fawziah Marra2

  • 1Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.

Canadian Journal of Public Health = Revue Canadienne De Sante Publique
|February 29, 2020
PubMed

Insights

Paediatric antibiotic prescribing has increased, particularly in young children (0-2 years), signaling a need for new antimicrobial stewardship targets. This study highlights rising trends and specific drug classes requiring attention.

Area of Science:

  • Public Health
  • Pediatric Pharmacology
  • Antimicrobial Stewardship

Background:

  • Antibiotic prescribing is common in pediatric care, often for self-limiting viral infections like upper respiratory tract infections.
  • Previous studies in British Columbia indicated decreasing or static antibiotic prescribing rates.
  • There is a need to identify new targets for provincial antimicrobial stewardship programs.

Purpose of the Study:

  • To identify potential new targets for provincial antimicrobial stewardship efforts in pediatric care.
  • To analyze trends in antibiotic utilization among children in a provincial healthcare system.

Main Methods:

  • Extracted pediatric antibiotic prescription data from a provincial database.
  • Linked prescription data with physician billing and demographic data for diagnostic and patient information.
  • Calculated prescription rates and examined trends by Anatomical Therapeutic Chemical (ATC) classification.

Main Results:

  • The study included an average of 271,134 children annually, with 1,767,652 antibiotic prescriptions.
  • Overall antibiotic utilization increased by 4.5% (453 to 474 prescriptions per 1000 population).
  • The greatest prescribing increases were observed in children aged 0-2 years across all categories, despite a decrease in upper respiratory tract infection prescriptions.

Conclusions:

  • Contrary to past findings, pediatric antibiotic prescribing rates have been increasing since 2013.
  • While broad-spectrum penicillin use has decreased, significant increases in tetracyclines, quinolones, and other antibacterials indicate new targets for stewardship.
  • These findings highlight a potential problem in pediatric antibiotic prescribing and necessitate updated stewardship strategies.
Abstract

Keywords:
AntibioticsAntimicrobial stewardshipPaediatricsResistance

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