G Edward Miller1, Julie Hudson. 1. Division of Modeling and Simulation, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland 20850, USA. emiller@ahrq.gov
Abstract
OBJECTIVES: We investigated trends in antibiotic use by U.S. children, from 1996 to 2001, a period that followed the launch of national campaigns to promote the appropriate use of antibiotics. DATA AND METHODS: We used nationally representative data from the Medical Expenditure Panel Survey for the years 1996-2001 to examine trends in antibiotic use and the contributions of changes in ambulatory visits and prescribing to these trends. We investigated trends in the use of antibiotics overall and for respiratory tract infections and examined these trends within subgroups of children defined by race/ethnicity and income. RESULTS: From 1996 to 2001, the proportion of children with antibiotic use overall and for respiratory tract infections decreased by 8.5 percentage points and 5.1 percentage points, respectively. Overall, the probability of a child having an ambulatory visit did not change. The decrease in overall antibiotic use resulted entirely from an increase in the probability that a child had an ambulatory visit(s) with no antibiotic use. By contrast, a decline in the probability that a child had a visit for a respiratory tract infection accounted for two-thirds of the reduction in antibiotic use for these conditions. The decline in overall use for white-other non-Hispanic children (-10.2 percentage points) was more than double the decline for black non-Hispanic or Hispanic children. CONCLUSION: Children's use of antibiotics, overall and for respiratory tract infections, showed significant declines from 1996 to 2001. The apparent response to campaigns to reduce inappropriate antibiotic use was widespread as reductions in use were found in all subgroups of children examined.
OBJECTIVES: We investigated trends in antibiotic use by U.S. children, from 1996 to 2001, a period that followed the launch of national campaigns to promote the appropriate use of antibiotics. DATA AND METHODS: We used nationally representative data from the Medical Expenditure Panel Survey for the years 1996-2001 to examine trends in antibiotic use and the contributions of changes in ambulatory visits and prescribing to these trends. We investigated trends in the use of antibiotics overall and for respiratory tract infections and examined these trends within subgroups of children defined by race/ethnicity and income. RESULTS: From 1996 to 2001, the proportion of children with antibiotic use overall and for respiratory tract infections decreased by 8.5 percentage points and 5.1 percentage points, respectively. Overall, the probability of a child having an ambulatory visit did not change. The decrease in overall antibiotic use resulted entirely from an increase in the probability that a child had an ambulatory visit(s) with no antibiotic use. By contrast, a decline in the probability that a child had a visit for a respiratory tract infection accounted for two-thirds of the reduction in antibiotic use for these conditions. The decline in overall use for white-other non-Hispanic children (-10.2 percentage points) was more than double the decline for black non-Hispanic or Hispanic children. CONCLUSION:Children's use of antibiotics, overall and for respiratory tract infections, showed significant declines from 1996 to 2001. The apparent response to campaigns to reduce inappropriate antibiotic use was widespread as reductions in use were found in all subgroups of children examined.