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The Effect of the COVID-19 Pandemic on Outpatient Antibiotic Prescription Rates in Children and Adolescents-A

Manas K Akmatov1, Claudia Kohring1, Lotte Dammertz1

  • 1Department of Epidemiology and Health Care Atlas, Central Research Institute of Ambulatory Health Care, 10587 Berlin, Germany.

Antibiotics (Basel, Switzerland)
|October 27, 2022
PubMed

Insights

The COVID-19 pandemic significantly reduced antibiotic prescriptions in German children, with rates dropping sharply during mitigation measures. However, this effect was temporary, and regional prescribing differences persisted.

Area of Science:

  • Pediatrics
  • Epidemiology
  • Public Health

Background:

  • The COVID-19 pandemic and associated mitigation measures may have impacted healthcare utilization and infectious disease patterns.
  • Understanding changes in antibiotic prescription rates during the pandemic is crucial for monitoring antimicrobial resistance and public health trends.
  • Previous trends showed a consistent decrease in antibiotic prescriptions for children in Germany prior to 2020.

Purpose of the Study:

  • To investigate the effect of the COVID-19 pandemic and related mitigation strategies on systemic antibiotic prescription rates among children (0-14 years) in Germany.
  • To analyze temporal trends and regional variations in antibiotic prescribing before and during the pandemic.

Main Methods:

  • Utilized nationwide outpatient prescription data from Statutory Health Insurance in Germany (2010-2021).
  • Examined monthly antibiotic prescriptions for children aged 0-14 years (n=9,688,483 in 2021).
  • Applied interrupted time series analysis to assess the impact of SARS-COV-2 mitigation measures implemented in March and November 2020.

Main Results:

  • Antibiotic prescription rates showed a consistent annual decrease of 6% from 2010-2019.
  • Mitigation measures in 2020 led to immediate and significant reductions in antibiotic prescriptions, particularly in April (RR 0.24) and November (RR 0.44).
  • Decreases were observed across all age groups and antibiotic subgroups, but the effect was temporary. Regional prescription rates remained highly correlated with pre-pandemic levels.

Conclusions:

  • The COVID-19 pandemic mitigation measures temporarily reduced antibiotic prescribing in German children, potentially due to decreased respiratory infections or altered healthcare access/seeking behaviors.
  • Despite significant reductions, high regional variations in antibiotic use persisted, mirroring pre-pandemic patterns.
  • Long-term implications for antimicrobial stewardship and healthcare access require further investigation.

Keywords:
COVID-19GermanySARS-CoV-2adolescentsantibioticschildrenclaims dataprescription rates

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