TITLE

Decrease in antibiotic use among children in the 1990s: not all antibiotics, not all children

AUTHOR(S)
Kozyrskyj, Anita L.; Carrie, Anita G.; Mazowita, Garey B.; Lix, Lisa M.; Klassen, Terry P.; Law, Barbara J.
PUB. DATE
July 2004
SOURCE
CMAJ: Canadian Medical Association Journal;7/20/2004, Vol. 171 Issue 2, p133
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Decreases in antibiotic use were widely reported in the 1990s. This study was undertaken to determine trends in the use of antibiotics from fiscal year (FY) 1995 (April 1995 to March 1996) to FY 2001 in a complete population of Mani-toba children. Methods: Using Manitoba's health care databases, we determined annual population-based rates of antibiotic prescription among children by antibiotic class (narrow-spectrum and broader-spectrum antibiotics), age group, physician diagnosis (e.g., otitis media or bronchitis) and neighbourhood income in urban ar-eas (derived from the 1996 census). Antibiotic prescription rates were generated within a generalized linear model frame-work with general estimating equations, and differences be-tween FY 2001 and FY 1995 were tested. Differences in antibi-otic use over time were compared across antibiotic classes, age groups, diagnoses and income neighbourhoods. Results: The overall antibiotic prescription rate decreased by almost one-third, from 1.2 prescriptions per child in FY 1995 to 0.9 prescriptions in FY 2001. Total antibiotic use declined for all respiratory tract infections; decreases were greatest for the sul-fonamides (decrease to less than one-third the FY 1995 rate) and narrow-spectrum macrolides (decrease to less than half the FY 1995 rate). In contrast, the FY 2001 rate for broader-spectrum macrolides was as much as 12.5 times the FY 1995 rate. Otitis media accounted for one-quarter of the use of the latter agents. Preschool children and low-income children received the great-est number of antibiotic prescriptions. Declines in antibiotic pre-scriptions were of a lesser magnitude for low-income children (for whom rates in FY 2001 were four-fifths the rates in FY 1995) than for higher-income children (for whom rates in FY 2001 were about two-thirds the rates in FY 1995). Interpretation: Overall, antibiotic use declined over the late 1990s in this population of Canadian...
ACCESSION #
13705724

 

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