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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Gradual decline in outpatient antibiotic prescriptions in paediatrics: A data warehouse-based 11-year cohort study

Leslie Grammatico-Guillon1,2, S Reza Jafarzadeh3, Emeline Laurent2,4

  • 1Medical School and School of Public Health, Boston University, Boston, MA, USA.

Acta Paediatrica (Oslo, Norway : 1992)
|June 24, 2020
PubMed

Insights

Antibiotic prescriptions in children decreased by over 5% annually from 2007-2017. This decline was observed across common antibiotic classes and was more pronounced in children with comorbid conditions, highlighting effective antimicrobial stewardship.

Area of Science:

  • Pediatric primary care
  • Antimicrobial stewardship
  • Public health surveillance

Background:

  • Antibiotic (AB) resistance is a growing global concern.
  • Understanding trends in pediatric antibiotic prescribing is crucial for effective antimicrobial stewardship.
  • Primary care settings are significant contributors to overall antibiotic use.

Purpose of the Study:

  • To describe trends in antibiotic prescriptions in children in primary care over an 11-year period.
  • To analyze the evolution of pediatric outpatient antibiotic prescriptions using time-series analyses.
  • To assess the impact of comorbid conditions on antibiotic prescribing patterns in children.

Main Methods:

  • Retrospective cohort study utilizing a large data warehouse (Massachusetts Health Disparities Repository).
  • Analysis of outpatient antibiotic prescriptions from 2007 to 2017.
  • Time-series analyses, including annual percent change (APC), were used to assess prescription trends.

Main Results:

  • Approximately 25,000 children were included, with 31,248 antibiotic prescriptions recorded.
  • Younger children received more antibiotic prescriptions.
  • Overall antibiotic prescriptions decreased by an average of 5.34% annually (APC = -5.34%).
  • Penicillins (46%) and macrolides (28%) were the most frequently prescribed antibiotic classes.
  • Children with comorbid conditions received significantly more antibiotics (30.3 vs 21.0 AB/100 child-years).
  • Antibiotic prescribing declined more substantially in children with comorbid conditions.

Conclusions:

  • Outpatient antibiotic prescribing in pediatrics demonstrated a gradual and consistent decline over the study period.
  • Persistent prescription differences were noted across age groups, conditions, and indications.
  • Routine care data warehouses facilitate automated surveillance, offering cost-effective tools for antimicrobial stewardship programs.
Abstract

Keywords:
cohort studydata warehousepaediatric antibiotic prescriptionroutinely collected data

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