Antibiotic Prescribing in Outpatient Children: A Cohort From a Clinical Data Warehouse

• Published in: Clinical pediatrics Vol. 58; no. 6; p. 681
• Main Authors: Grammatico-Guillon, Leslie, Shea, Kimberly, Jafarzadeh, S Reza, Camelo, Ingrid, Maakaroun-Vermesse, Zoha, Figueira, Marisol, Adams, William G, Pelton, Steve
• Format: Journal Article
• Language: English
• Published: United States 01.06.2019
• Subjects: Ambulatory Care - methods; Anti-Bacterial Agents - therapeutic use; Antimicrobial Stewardship; Child; Child, Preschool; Cohort Studies; Data Warehousing; Drug Prescriptions - statistics & numerical data; Drug Utilization; Female; Humans; Inappropriate Prescribing - statistics & numerical data; Infant; Male; Massachusetts; Microbial Sensitivity Tests; Outpatients - statistics & numerical data; Respiratory Tract Infections - diagnosis; Respiratory Tract Infections - drug therapy; Retrospective Studies; Urinary Tract Infections - diagnosis; Urinary Tract Infections - drug therapy; Massachusetts; antibiotherapy; data warehouse; primary care; pediatric
• ISSN: 1938-2707
• DOI: 10.1177/0009922819834278

To characterize antibiotic (ab) prescriptions in children. Evaluation of outpatient ab prescriptions in a 3-year cohort of children in primary care using a data warehouse (Massachusetts Health Disparities Repository) by comorbid conditions, demographics, and clinical indication. A total of 15 208 children with nearly 120 000 outpatient visits were included. About one third had a comorbid condition (most commonly asthma). Among the 30 000 ab prescriptions, first-line penicillins and macrolides represented the most frequent ab (70%), followed by cephalosporins (16%). Comorbid children had 54.3 ab prescriptions/100 child-years versus 38.8 in children without comorbidity; ab prescription was higher in urinary tract infections (>60% of episodes), otitis, lower respiratory tract infections (>50%), especially in comorbid children and children under 2 year old. Ab prescriptions were significantly associated with younger age, emergency room visit, comorbid children, and acute infections. A clinical data warehouse could help in designing appropriate antimicrobial stewardship programs and represent a potential assessment tool.