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J Pediatr. 2017 Mar;182:239-244.e1. doi: 10.1016/j.jpeds.2016.11.027. Epub 2016 Dec 21.

Antibiotic Use in Children - A Cross-National Analysis of 6 Countries.

Author information

1
Division of Infectious Diseases, Boston Children's Hospital, Boston, MA. Electronic address: ilan.youngster@childrens.harvard.edu.
2
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
3
Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
4
Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
5
Health Services Research Unit, Center for Public Health Research, Valencia, Spain.
6
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
7
Wissenschaftliches Institut der AOK WIdO (Scientific Institute of the AOK), Berlin, Germany.
8
Korea Institute of Drug Safety and Risk Management, Seoul, Republic of Korea.
9
Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway.
10
Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo, Norway.
11
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
12
Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Abstract

OBJECTIVES:

To describe the rates of pediatric antibiotic use across 6 countries on 3 continents.

STUDY DESIGN:

Cross-national analysis of 7 pediatric cohorts in 6 countries (Germany, Italy, South Korea, Norway, Spain, and the US) was performed for 2008-2012. Antibiotic dispensings were identified and grouped into subclasses. We calculated the rates of antimicrobial prescriptions per person-year specific to each age group, comparing the rates across different countries.

RESULTS:

A total of 74 744 302 person-years from all participating centers were included in this analysis. Infants in South Korea had the highest rate of antimicrobial consumption, with 3.41 prescribed courses per child-year during the first 2 years of life. This compares with 1.6 in Lazio, Italy; 1.4 in Pedianet, Italy; 1.5 in Spain; 1.1 in the US; 1.0 in Germany; and 0.5 courses per child-year in Norway. Of antimicrobial prescriptions written in Norway, 64.8% were for first-line penicillins, compared with 38.2% in Germany, 31.8% in the US, 27.7% in Spain, 25.1% in the Italian Pedianet population, 9.8% in South Korea, and 8% in the Italian Lazio population.

CONCLUSIONS:

We found substantial differences of up to 7.5-fold in pediatric antimicrobial use across several industrialized countries from Europe, Asia, and North America. These data reinforce the need to develop strategies to decrease the unnecessary use of antimicrobial agents.

KEYWORDS:

antibiotics; children; cross-national analysis

PMID:
28012694
DOI:
10.1016/j.jpeds.2016.11.027
[Indexed for MEDLINE]

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