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Gradual decline in outpatient antibiotic prescriptions in paediatrics: A data warehouse–based 11‐year cohort study
Author(s) -
GrammaticoGuillon Leslie,
Jafarzadeh S. Reza,
Laurent Emeline,
Shea Kimberly,
Pasco Jeremy,
Astagneau Pascal,
Adams William,
Pelton Stephen
Publication year - 2021
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15439
Subject(s) - medicine , medical prescription , antimicrobial stewardship , pediatrics , retrospective cohort study , cohort , cohort study , pharmacoepidemiology , population , emergency medicine , antibiotics , database , environmental health , antibiotic resistance , pharmacology , computer science , microbiology and biotechnology , biology
Abstract Aim To describe trends in antibiotic (AB) prescriptions in children in primary care over 11 years, using a large data warehouse. Methods A retrospective cohort study assessed outpatient AB prescriptions 2007‐2017, using the Massachusetts Health Disparities Repository. The evolution of paediatric outpatient AB prescriptions was assessed using time‐series analyses through annual per cent change (APC) for the population and for children with or without comorbid condition. Results About 25 000 children were followed in primary care with 31 248 AB prescriptions reported in the data warehouse. The youngest children had more AB prescriptions. Penicillins were prescribed most frequently (46%), then macrolides (28%). One third of children had comorbid conditions, receiving significantly more antibiotics (30.3 vs 21.0 AB/100 child‐years, relative risk: 1.43, 95% CI: 1.40, 1.46). Overall AB prescription decreased over the period (APC = −5.34%, 95% CI: −7.10, −3.54), with similar trends for penicillins (APC = −5.49; 95% CI: −8.27, −2.62) and macrolides (APC = −6.46; 95% CI: −8.37, −4.58); antibiotic prescribing declined more in children with comorbid conditions. Conclusion Outpatient AB prescribing decline was gradual and consistent in paediatrics over the period. Prescription differences persisted between age groups, conditions and indication. The availability of routine care data through data warehouse fosters the surveillance automation, providing inexpensive fast tools to design appropriate antimicrobial stewardship.