Abstract
OBJECTIVE: To assess changes in antibiotic prescribing patterns for children between 1987 and 2001, and to identify general practice characteristics associated with higher antibiotic prescribing rates.
METHODS: Cross-sectional national survey of Dutch general practice in 1987 and 2001. Data were used for all children aged 0-17 years; 86 577 children in 103 participating practices in 1987, and 76 010 children in 90 participating practices in 2001. Population-based, contact-based and disease-based antibiotic prescription rates were evaluated by age, gender and diagnosis. Practice characteristics associated with inappropriate broad-spectrum antibiotic prescription were identified.
RESULTS: Population-based prescription rates decreased from 300/1000 children (95% CI, 292-307) in 1987 to 232/1000 children in 2001 (95% CI, 228-235). In 1987, the contact-based prescription rate was 108/1000 contacts (95% CI, 106-111) and this was somewhat similar in 2001: 103/1000 contacts (95% CI, 101-105). In 2001, increased disease-based prescription rates were observed for acute otitis media, acute bronchitis, acute upper airway infections, acute tonsillitis and cough. Overall, non-recommended broad-spectrum antibiotics were prescribed more often in 2001 than in 1987 (87% in 1987 versus 90% in 2001, P < 0.001). Adjusted for other practice characteristics, general practitioners in single-handed practices prescribed 58% more broad-spectrum antibiotics inappropriately for upper airway infections than general practitioners in group practices.
CONCLUSION: Antibiotic prescribing in children is still relatively low in the Netherlands. However, the prescription of broad-spectrum antibiotics for inappropriate diagnoses has increased, an unfavourable trend given the emerging bacterial resistance. Single-handed practices should especially be targeted to improve antibiotic prescribing in children.
Original language | English |
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Pages (from-to) | 361-6 |
Number of pages | 6 |
Journal | Journal of antimicrobial chemotherapy |
Volume | 53 |
Issue number | 2 |
DOIs | |
Publication status | Published - Feb 2004 |
Keywords
- Adolescent
- Age Factors
- Anti-Bacterial Agents/therapeutic use
- Bacterial Infections/drug therapy
- Child
- Child, Preschool
- Cross-Sectional Studies
- Data Collection
- Drug Prescriptions/statistics & numerical data
- Drug Utilization/trends
- Family Practice/statistics & numerical data
- Female
- Humans
- Infant
- Male
- Netherlands/epidemiology
- Population
- Sex Factors