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

Clin Pediatr (Phila). 2019 Jun;58(6):681-690. doi: 10.1177/0009922819834278. Epub 2019 Mar 19.

Abstract

Aim: To characterize antibiotic (ab) prescriptions in children.

Methods: 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.

Results: 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.

Discussion: A clinical data warehouse could help in designing appropriate antimicrobial stewardship programs and represent a potential assessment tool.

Keywords: antibiotherapy; data warehouse; pediatric; primary care.

MeSH terms

  • 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*

Substances

  • Anti-Bacterial Agents