Antibiotic prescribing to Kentucky Medicaid children, 2012‐2017: Prescribing is higher in rural areas

• Published in: The Journal of rural health Vol. 38; no. 2; pp. 427 - 432
• Main Authors: Wattles, Bethany A., Vidwan, Navjyot K., Feygin, Yana, Jawad, Kahir S., Creel, Liza M., Smith, Michael J.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.03.2022
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotic resistance; antibiotic stewardship; antibiotic use; Antibiotics; Antimicrobial Stewardship; Child; Child, Preschool; Children; Family physicians; Female; Government programs; Health problems; Health risks; health services research; Humans; Kentucky; Male; Management; Medicaid; Nurse practitioners; Patients; Pediatricians; Pediatrics; Prescribing; Prescription drugs; Public health; Resistance; Rural areas; rural children; Rural communities; United States; United States; Kentucky; United States > US; rural children; health services research; antibiotic use; antibiotic stewardship; Medicaid
• ISSN: 0890-765X; 1748-0361
• DOI: 10.1111/jrh.12584

Purpose Antibiotic resistance is a major public health threat. Antibiotic use is the main driver of resistance, with children and the state of Kentucky having particularly high rates of outpatient antibiotic prescribing. The purpose of this study was to describe patient and provider characteristics associated with pediatric antibiotic use in Kentucky Medicaid children. Methods We used Medicaid prescription claims data from 2012 to 2017 to describe patterns of pediatric antibiotic receipt in Kentucky. Patient and provider variables were analyzed to identify variations in prescribing. Findings Children who were female, less than 2 years old, White, and living in a rural area had consistently higher rates of antibiotic prescriptions. There was significant geographic variability in prescribing, with children in Eastern Kentucky receiving more than 3 courses of antibiotics a year. Most antibiotic prescriptions for children were written by general practitioners and nurse practitioners rather than pediatricians. Conclusion These findings support the need for extensive antibiotic stewardship efforts inclusive of rural outpatient practices.