[Temporal trend of antibiotic use among primary school children in Shanghai, 2017-2020]

Area of Science:

• Pediatric infectious diseases
• Antimicrobial stewardship
• Public health surveillance

Background:

• Antibiotic resistance is a growing global health concern.
• Understanding pediatric antibiotic use patterns is crucial for effective interventions.
• Limited data exists on temporal trends of antibiotic consumption in Chinese children.

Purpose of the Study:

• To investigate the temporal trends of antibiotic use among children in Shanghai between 2017 and 2020.
• To analyze the changes in the use rates of various antibiotic classes over time.
• To identify factors influencing antibiotic consumption in a pediatric cohort.

Main Methods:

• A dynamic cohort of 700 healthy children (aged 7-11) was established using stratified cluster sampling in Shanghai.
• Annual questionnaires collected data on basic information and antibiotic use.
• Height and weight were measured, and statistical analyses included Chi-square tests and generalized estimation equations.
• Antibiotic use rates for all antibiotics, cephalosporins, azithromycin, and other classes were calculated.

Main Results:

• Overall antibiotic use rate was 15.6%, cephalosporins 10.5%, azithromycin 2.7%, and other antibiotics 2.4% between 2017-2020.
• Significant differences in the use rates of total and other antibiotics were observed annually (P=0.033, P=0.040).
• Generalized estimation equations revealed a decreasing temporal trend in the annual use rates of all antibiotics, cephalosporins, and other antibiotics after adjustment.

Conclusions:

• The study observed a declining trend in the overall antibiotic use, cephalosporins, and other antibiotic classes among children in Shanghai from 2017 to 2020.
• These findings suggest potential improvements in pediatric antibiotic prescribing practices.
• Continued monitoring and targeted interventions are essential to further optimize antibiotic use in children.