Related Experiment Video
Updated: Jul 4, 2025
A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
Variations in antibiotic prescribing among children enrolled in North Carolina Medicaid, 2013-2019
Ganga S Moorthy1,2,3, Rebecca R Young4, Sudha R Raman5
1Division of Pediatric Infectious Diseases, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA.
Insights
Pediatric antibiotic prescribing in North Carolina (NC) shows disparities. Younger, White, and rural children received more prescriptions, with higher inappropriate use in rural areas, highlighting the need for equitable stewardship efforts.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial stewardship
- Health equity research
Background:
- Pediatric antibiotic prescribing is frequent in outpatient settings.
- Inappropriate antibiotic use drives antimicrobial resistance.
- Regional variations in antibiotic use exist, notably high in Southern states.
Purpose of the Study:
- To determine rates and risk factors for inappropriate antibiotic prescriptions in North Carolina (NC) pediatric Medicaid patients.
- To analyze patient and provider factors influencing pediatric antibiotic prescribing patterns.
Main Methods:
- Utilized NC Medicaid prescription claims data from 2013 to 2019.
- Described pediatric antibiotic prescription patterns.
- Assessed patient and provider characteristics associated with prescribing variations.
Main Results:
- Children under 2, non-Hispanic White, and rural children had the highest antibiotic prescription rates.
- Inappropriate antibiotic prescription risk was highest among non-pediatric specialists and lowest among nurse practitioners.
- Rural NC areas exhibited the highest inappropriate prescribing rates, with compounded risk for non-Hispanic Black children in these areas.
Conclusions:
- NC prescribing practices differ from neighboring states, with lower inappropriate use risk in Appalachia but persistent racial and rural disparities.
- Outpatient stewardship must address racial and geographic variations.
- Education for all healthcare providers is crucial for promoting health equity in prescribing.
Purpose:
The majority of pediatric antibiotic prescribing occurs in the outpatient setting and inappropriate use contributes to antimicrobial resistance. There are regional variations in outpatient antibiotic use with the highest rates occurring in the Southern states, including in Appalachia. The purpose of this study was to describe the rates and risk factors for inappropriate antibiotic prescription among pediatric patients enrolled in North Carolina (NC) Medicaid.
Methods:
We used Medicaid prescription claims data from 2013 to 2019 to describe patterns of pediatric antibiotic prescription in NC. We assessed patient and provider factors to identify variations in prescribing.
Findings:
Children who were less than 2 years of age, non-Hispanic White, and living in a rural area had the highest overall rates of antibiotic prescription. Compared to pediatricians, the risk of inappropriate antibiotic prescription was highest among other specialists and general practioners and lowest among nurse practitioners. Rural areas of NC had the highest rates of inappropriate antibiotic prescribing, and the risk for non-Hispanic Black children compared to children of other races/ethnicities was compounded by rurality.
Conclusions:
Prescribing practices in NC differ compared to neighboring states with a lower overall risk of inappropriate prescription in Appalachian regions; however, disparities by race and rurality exist. Outpatient stewardship efforts in NC should focus on ensuring health equity by appreciating racial and geographic variations in prescribing patterns and providing education to all health care providers.
More Related Videos
11:17Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
08:33Quantitative Polymerase Chain Reaction-based Analyses of Murine Intestinal Microbiota After Oral Antibiotic Treatment
Published on: November 17, 2018
Related Concept Videos
01:21Factors Affecting Drug Response: Overview
01:02Prescription, Nonprescription and Orphan Drugs
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:15Drug Dosage Regimen: Overview
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
01:19Factors Affecting Drug Distribution: Miscellaneous Factors
Age plays a significant role due to differences in body composition among different age groups. Infants, for instance, have a higher proportion of total body water and lower albumin levels, a protein that binds drugs in the bloodstream. This unique composition in infants enhances the...
00:57Antibiotic Selection