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Message received on judicious use of antibiotics
The number of prescriptions written for antibiotics has gone down, which may indicate that clinicians are getting the message when it comes to judicious use of these medications, according to study findings published online.
However, as the number of prescribed antibiotics has decreased, the number of prescriptions for attention-deficit/hyperactivity disorder has increased.
Grace Chai, PharmD, of the Office of Surveillance and Epidemiology, Division of Epidemiology II, Center for Drug Evaluation and Research at the FDA, and colleagues examined data from several national prescription databases to analyze prescription patterns for children.
The researchers noted a 7% drop between 2002 and 2010 in overall prescription rates written for children, despite a 22% rise in prescriptions written for adults during that same study period.
Chai and colleagues reported a marked increase in prescriptions ordered for children with asthma and ADHD; but noted reductions in prescriptions for antibiotics, and drugs to treat allergies, pain and depression. They said several medications related to allergies have become available over-the-counter, which may have led to reductions in prescriptions for those medications.
The researchers said their data indicate efforts by the AAP and other physician organizations to education about judicious use of antibiotics are having an effect.
“A variety of initiatives have been launched in the past decade promoting the judicious use of antibiotics, particularly for acute respiratory tract infections and acute otitis media. Our analyses suggest such efforts may be working,” the study researchers wrote.
They also said increases in prescriptions for ADHD medications parallel the rise in children diagnosed with the condition, from 4.4 million to 5 million, during the study period.
In a statement released to Infectious Diseases in Children, a spokesperson for the FDA said: “It is important for FDA to find out how drugs are being used in the real world. One helpful result of compiling data like this is that areas of extensive ‘off-label’ use can be identified, providing insight into where potential study on the safety and effectiveness in children may be needed.”
The researchers noted that data like these are important to identify gaps in research.
Disclosure: Dr. Chai reports no relevant financial disclosures.
Perspective
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Epidemiological and drug utilization data in pediatrics such as that provided by Chai and colleagues are always welcomed, as fewer data exist for children as compared to the adults. Although these data do not describe the therapeutic use or validity of medication use in children, trends in medication use, by specific medication as well medication category, highlight areas for further research and investigation. It is heartening to notice that antibiotic use, although still the most commonly used medication category, has declined from 2002 to 2010. This certainly may reflect recent efforts by national organizations to decrease inappropriate antibiotic use.
While medicines for pain also decreased overall from 2002-2010, analgesics (codeine and hydrocodone) still remained in the top half of the 30 most frequently dispensed medicines for this time period. In light of recent concerns raised about the dangers of stronger analgesics, this may represent an area for further investigation.
