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Rate of prescribed antibiotics increased, remains stable
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The prescribing rate for antibiotics experienced an increase in the use of beta-lactam penicillin but otherwise remained stable at a high level among Danish children during a 12-year period, according to study findings in The Pediatric Infectious Disease Journal.
Anton Pottegård, MSc Pharm, of the University of Southern Denmark, in Odense, Denmark, and colleagues assessed data on prescriptions and antibiotic use among children, aged 0 to 11 years, from January 2000 to December 2012. Data was from the Danish National Prescription Database.
There were 5,884,301 prescriptions for systemic antibiotics issued to 1,206,107 children during the study period. The most used substances were phenoxymethylpenicillin (45.4%); amoxicillin (33.7%); and erythromycin (5.8%).
Children aged younger than 2 years had the highest rate of antibiotic treatment, at 827 treatments per 1,000 years of follow-up in 2012. Regarding one-year prevalence, children aged 0 to 1 year had a rate of 485 treatments per 1,000 children; children aged 2 to 4 years had a rate of 363 treatments per 1,000 children; and children aged 5 to 11 years had a rate of 190 treatments per 1,000 children. Antibiotic treatment incidence rates peaked when children were aged 1 year.
Antibiotic treatment was slightly more common among boys vs. girls until the age of 4 years; after that, the opposite pattern occurred.
Beta-lactam antibacterial penicillins were the most commonly used antibiotics, though use of macrolides were significant as well, according to the researchers. During the study period, there was a small decrease in use of phenoxymethylpenicillin and an increase in amoxicillin, most notably among children younger than 2 years. The prescribing rate for amoxicillin with an enzyme inhibitor significantly increased during the study period. Among children younger than 1 year, the prescribing rate for amoxicillin increased from 7 to 30 per 1,000 person-years.
The overall use of macrolides decreased, most significantly among children aged 0 to 1 year. There was a decrease in the prescription of erythromycin and an increase in the prescription of clarithromycin.
“In summary, prescribing rate of antibiotics to children in Denmark remained overall stable at a high level during 2000 to 2012. A disturbing increase in use of broad-spectrum beta-lactam penicillin was noted, but otherwise the prescribing pattern adheres well to national guidelines with respect to choice of antibiotics. Whether the indications for prescribing justify the high use of antibiotics in children should be subject to future studies,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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