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White children twice as likely to receive unnecessary antibiotics in ED
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Compared with Hispanic or black children, white children were nearly twice as likely to receive antibiotics in the ED for the treatment of viral acute respiratory tract infections.
“Racial and ethnic differences in pediatric emergency care have been described in CT utilization for minor head trauma, performance of laboratory and radiologic testing, hospital admission rates and pain management in children diagnosed with appendicitis but have not previously been explored for antibiotic prescribing,” Monika K. Goyal, MD, MSCE, from the departments of pediatrics and emergency medicine at Children’s National Health System in The George Washington University, and colleagues wrote.
“Acute respiratory tract infections are among the most common reasons that parents seek medical care for their children, and they account for about 75% of antibiotic prescribing to children despite most of these infections being caused by viruses,” the researchers continued.
To examine if antibiotic prescribing is affected by the race and ethnicity of patients in a pediatric ED with acute respiratory tract infections, the researchers conducted a retrospective cohort study that included treatments at seven pediatric ED in 2013. The Pediatric Emergency Care Applied Research Network Registry was also used to gather electronic health data.
Goyal and colleagues used multivariable logistic regression to assess the connection between race/ethnicity and children who were discharged with viral acute respiratory tract infection who were prescribed or administered antibiotics. To meet inclusion criteria, the children must not have had a bacterial codiagnosis, chronic disease or be immunocompromised.
Among the patients treated for viral acute respiratory tract infections (n = 39,445), 2.6% were administered antibiotics (95% CI, 2.4%-2.8%), including children who were non-Hispanic white (4.3%), non-Hispanic black (1.9%), Hispanic (2.6%) and other non-Hispanic (2.9%). Despite multivariable analyses, non-Hispanic black (aOR: 0.44; CI 0.36-0.53), Hispanic (aOR: 0.65; CI 0.53-0.81) and other non-Hispanic children (aOR 0.68; CI 0.52-0.87) were still less likely to be administered antibiotics.
“It is encouraging that just 2.6% of children treated in pediatric EDs across the nation received antibiotics for viral acute respiratory tract infections since antibiotics are ineffective in treating viral infections,” Goyal said in a press release. “However, it is troubling to see such persistent racial and ethnic differences in how medications are prescribed, in this case in the ED. It may come down to factors as simple as providers or parents believing that ‘more is better,’ despite the clear public health risks of prescribing children antibiotics unnecessarily.”– by Katherine Bortz
Disclosure: The researchers report no relevant financial disclosures.
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