OBJECTIVE: The goal of this study was to determine changes in antibiotic-dispensing rates among children in 3 health plans located in New England [A], the Mountain West [B], and the Midwest [C] regions of the United States. METHODS: Pharmacy and outpatient claims from September 2000 to August 2010 were used to calculate rates of antibiotic dispensing per person-year for children aged 3 months to 18 years. Differences in rates by year, diagnosis, and health plan were tested by using Poisson regression. The data were analyzed to determine whether there was a change in the rate of decline over time. RESULTS: Antibiotic use in the 3- to <24-month age group varied at baseline according to health plan (A: 2.27, B: 1.40, C: 2.23 antibiotics per person-year; P < .001). The downward trend in antibiotic dispensing slowed, stabilized, or reversed during this 10-year period. In the 3- to <24-month age group, we observed 5.0%, 9.3%, and 7.2% annual declines early in the decade in the 3 plans, respectively. These dropped to 2.4%, 2.1%, and 0.5% annual declines by the end of the decade. Third-generation cephalosporin use for otitis media increased 1.6-, 15-, and 5.5-fold in plans A, B, and C in young children. Similar attenuation of decline in antibiotic use and increases in use of broad-spectrum agents were seen in other age groups. CONCLUSIONS: Antibiotic dispensing for children may have reached a new plateau. Along with identifying best practices in low-prescribing areas, decreasing broad-spectrum use for particular conditions should be a continuing focus of intervention efforts.
OBJECTIVE: The goal of this study was to determine changes in antibiotic-dispensing rates among children in 3 health plans located in New England [A], the Mountain West [B], and the Midwest [C] regions of the United States. METHODS: Pharmacy and outpatient claims from September 2000 to August 2010 were used to calculate rates of antibiotic dispensing per person-year for children aged 3 months to 18 years. Differences in rates by year, diagnosis, and health plan were tested by using Poisson regression. The data were analyzed to determine whether there was a change in the rate of decline over time. RESULTS: Antibiotic use in the 3- to <24-month age group varied at baseline according to health plan (A: 2.27, B: 1.40, C: 2.23 antibiotics per person-year; P < .001). The downward trend in antibiotic dispensing slowed, stabilized, or reversed during this 10-year period. In the 3- to <24-month age group, we observed 5.0%, 9.3%, and 7.2% annual declines early in the decade in the 3 plans, respectively. These dropped to 2.4%, 2.1%, and 0.5% annual declines by the end of the decade. Third-generation cephalosporin use for otitis media increased 1.6-, 15-, and 5.5-fold in plans A, B, and C in young children. Similar attenuation of decline in antibiotic use and increases in use of broad-spectrum agents were seen in other age groups. CONCLUSIONS: Antibiotic dispensing for children may have reached a new plateau. Along with identifying best practices in low-prescribing areas, decreasing broad-spectrum use for particular conditions should be a continuing focus of intervention efforts.
Authors: J A Finkelstein; R L Davis; S F Dowell; J P Metlay; S B Soumerai; S L Rifas-Shiman; M Higham; Z Miller; I Miroshnik; A Pedan; R Platt Journal: Pediatrics Date: 2001-07 Impact factor: 7.124
Authors: Jonathan A Finkelstein; Christopher Stille; James Nordin; Robert Davis; Marsha A Raebel; Douglas Roblin; Alan S Go; David Smith; Christine C Johnson; Kenneth Kleinman; K Arnold Chan; Richard Platt Journal: Pediatrics Date: 2003-09 Impact factor: 7.124
Authors: Gregory J Berry; Catherine R Miller; Mariana Moreno Prats; Christopher Marquez; Olajumoke O Oladipo; Michael J Loeffelholz; John R Petersen Journal: J Clin Microbiol Date: 2018-02-22 Impact factor: 5.948
Authors: Alan C Kinlaw; Til Stürmer; Jennifer L Lund; Lars Pedersen; Michael D Kappelman; Julie L Daniels; Trine Frøslev; Christina D Mack; Henrik Toft Sørensen Journal: Pediatrics Date: 2017-08-14 Impact factor: 7.124
Authors: Danielle L Palms; Lauri A Hicks; Monina Bartoces; Adam L Hersh; Rachel Zetts; David Y Hyun; Katherine E Fleming-Dutra Journal: JAMA Intern Med Date: 2018-09-01 Impact factor: 21.873
Authors: Ban Al-Sayyed; Jeremy Le; Mohammad Mousbah Al-Tabbaa; Brian Barnacle; Jinma Ren; Richard Tapping; Meenakshy Aiyer Journal: J Pediatr Pharmacol Ther Date: 2019 Jan-Feb