Inpharma 1344 - 29 Jun 2002

Antibacterial prescribing amongpaediatric individuals declining in

the USAntibacterial prescribing by office-based physicians

decreased significantly among paediatric individualsbetween 1989 and 2000 in the US, both overall and forrespiratory tract infections, say US-based researchers.1

Using NAMCS* data, the researchers assessedantibacterial prescribing by US office-based physiciansamong paediatric individuals aged less than 15 years, foreach 2-year period between 1989 and 2000. Resultsindicated that, while there were no significant changesin office-visit rates overall, the number of visits forrespiratory tract infection** declined by a significant34% from 1989–1990 to 1999–2000. Over this period,the average annual population-based rate ofantibacterial prescriptions per 1000 paediatricindividuals decreased significantly, both overall (838 vs503 antibacterials), and for respiratory tract infections,excluding sinusitis (674 vs 379). The average annualvisit-based rate of antibacterial prescriptions per 1000paediatric individuals also decreased significantly overthe study period, both overall (330 vs 234 antibacterials)and for pharyngitis and upper respiratory tractinfections. The decline in antibacterial prescribingcoincides with increased media attention focusing onantibacterial resistance, and efforts by manyorganisations to promote appropriate antibacterial use,the researchers conclude.

In an accompanying editorial, Dr Michael Pichicherofrom the University of Rochester Medical Center, US,notes that the overall decrease in paediatric antibacterialprescribing observed in this NAMCS follow-up study, ‘isgood news, if true’.2 However, ‘several factors other thanappropriate use’ may explain the decline, he says.Nevertheless, mathematical models predict that it maytake years or decades ‘ to see substantial reductions inthe frequency of antibiotic resistance solely as a result ofmore prudent use’, Dr Pichichero says.* National Ambulatory Medical Care Survey** for otitis media, bronchitis, pharyngitis, sinusitis and upperrespiratory tract infections

1. McCaig LF, et al. Trends in antimicrobial prescribing rates for children andadolescents. JAMA: the Journal of the American Medical Association 287:3096-3102, 19 Jun 2002.

2. Pichichero ME. Dynamics of antibiotic prescribing for children. JAMA: theJournal of the American Medical Association 287: 3133-3135, 19 Jun 2002.

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Inpharma 29 Jun 2002 No. 13441173-8324/10/1344-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved