Open AccessSocioeconomic Status and Determinants of Pediatric Antibiotic Use
Author(s) -
Andrew McGurn,
Brittany Watchmaker,
Kaavya Adam,
Jeff Ni,
Piotr Babinski,
Hannah Friedman,
Bridget Boyd,
Lara R. Dugas,
Talar Markossian
Publication year - 2020
Publication title -
clinical pediatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.387
H-Index - 64
eISSN - 1938-2707
pISSN - 0009-9228
DOI - 10.1177/0009922820941629
Subject(s) - medicine , socioeconomic status , poverty , emergency department , medical prescription , obesity , ethnic group , medicaid , demography , retrospective cohort study , gerontology , pediatrics , environmental health , health care , population , psychiatry , sociology , anthropology , economics , pharmacology , economic growth
. Evidence suggests that early-life antibiotic use can alter gut microbiome, predisposing children to obesity. The obesity epidemic has a disproportionate effect on individuals from lower socioeconomic status (SES). Thus, this study aims to explore the link between SES and antibiotic use. Design . We performed a retrospective cohort study of all babies born at and receiving 2 or more outpatient visits at a large, suburban health system in Illinois (United States) between 2007 and 2017. We collected data on zip code as a proxy for SES and antibiotic use in the first year of life. We also obtained comorbid diagnosis codes, race/ethnicity, gender, and number of inpatient, outpatient, and emergency department visits. Results . A total of 7224 patients met our study criteria. Children from low-poverty areas received a lifetime average of 4.28 prescriptions, while those from high-poverty neighborhoods received an average of 3.31 prescriptions. This was statistically significant in our unadjusted analysis but not after adjusting for covariates. Children from high-poverty areas were significantly more likely to receive more antibiotics at 48 hours, 1 week, and 1 month of life in our unadjusted analysis, but not after adjusting for covariates. In our unadjusted and adjusted analyses, children from high-poverty areas were significantly more likely to have received antibiotics at 1 week of life. Conclusion . The relationship between SES and antibiotic use warrants further investigation to help elucidate possible causes of the disproportionate impact obesity has in low-income communities.