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Published on: March 24, 2023
Patterns of Antibiotic Dispensing Among New Zealand Children: A Linkage Study
Sharan Ram1, Marine Corbin1, Amanda Kvalsvig2
1Center for Public Health Research, Massey University, Wellington, New Zealand.
Insights
Antibiotic dispensing is widespread in New Zealand children, with 96% receiving prescriptions by age five. Significant ethnic and socioeconomic disparities exist, indicating current stewardship programs need improvement.
Area of Science:
- Pediatric Health
- Pharmacology
- Public Health
Background:
- Antibiotic overuse fuels antibiotic resistance and gut microbiome dysbiosis.
- This dysbiosis may elevate the risk of chronic childhood conditions.
Purpose of the Study:
- To investigate antibiotic dispensing patterns in pregnant women and children up to five years old.
- To identify demographic and socioeconomic factors associated with antibiotic use.
Main Methods:
- Retrospective cohort study of 315,786 children born in New Zealand (2005-2010).
- Utilized linked pharmaceutical dispensing data for in-utero and postnatal antibiotic exposure.
- Employed descriptive analyses and negative binomial regression, controlling for confounders.
Main Results:
- 96% of children received ≥1 antibiotic course by age five; 30% of pregnant women received antibiotics.
- Amoxicillin was the most frequent prescription. Higher dispensing rates observed for males, Māori, Pacific peoples, MELAA ethnicities, highest deprivation quintile, preterm births, and urban children.
- Maternal antibiotic use during pregnancy showed similar demographic patterns. Dispensing peaked in winter.
Conclusions:
- High rates of antibiotic dispensing in New Zealand children and pregnant women are evident.
- Significant ethnic and socioeconomic disparities in antibiotic use were identified.
- Current antibiotic stewardship programs may not be fully effective in addressing these patterns.
Background:
Overuse of antibiotics contributes to antibiotic resistance, and may result in gut microbiome dysbiosis, potentially increasing the risk of chronic childhood conditions.
Objectives:
To examine patterns of antibiotic dispensing in utero and during the first 5 years of life.
Methods:
We conducted a retrospective cohort study of all children (n = 315 786) born in New Zealand from 2005 to 2010 using linked pharmaceutical dispensing data to ascertain antibiotic use during the mother's pregnancy and for the first 5 years of life. Descriptive analyses were conducted as well as negative binomial regression controlled for potential confounders.
Results:
In total, 96% of children had been dispensed ≥ 1 course of antibiotics by age five; for pregnant women this was 30%. Penicillin, particularly Amoxicillin, was most frequently dispensed during both periods. Postnatal antibiotic dispensing was higher for males (adjusted IRR 1.09, 95% CI 1.08-1.10); Māori (1.16, 1.15-1.17), Pacific peoples (1.32, 1.30-1.33), and Middle East Latin American and African (MELAA) ethnicities (1.07, 1.04-1.10); children in the highest deprivation quintile (1.16, 1.15-1.17) and those born pre-term (1.05, 1.04-1.05); and urban children (1.21, 1.20-1.22). Low and high birthweight and caesarean deliveries were also associated with higher antibiotic dispensing. Similar patterns were observed for antibiotic dispensing for mothers during pregnancy. Dispensing rates were highest during winter months.
Conclusion:
Antibiotic dispensing is high in New Zealand children and pregnant women, with significant ethnic and socioeconomic differences, suggesting that current antibiotic stewardship programmes are not fully effective.
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