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

Youngster I, Avorn J, Belleudi V, et al. J Pediatr. 2016 Dec 19.


Antimicrobial agents are the most commonly prescribed therapeutic agents in the pediatric population globally. Antibiotic overuse is a major public health problem and the single most important factor in the emergence of antibiotic resistance among respiratory bacterial pathogens through selection pressure. Recent studies have associated antibiotic use in infancy with a multitude of negative health-related consequences, including long-term reduction in microbiota diversity, increased risk for atopic diseases, obesity, and inflammatory bowel diseases.
Thus, as a public health policy, there is little doubt that overzealous prescribing habits and inappropriate use of antibiotics should be minimized individually and on a population level.
In recent years, as awareness of the potential adverse results associated with overuse of antibiotics are being increasingly recognized, antibiotic prescribing rates for children have declined. Country-specific campaigns to promote judicious antibiotic use likely made na important contribution to this change in pediatric practice. Nevertheless, it is still estimated that 50% of all pediatric antimicrobial prescriptions are unnecessary. Furthermore, some evidence has emerged that the downward trend in antibiotic prescription rates in children recently has been attenuated and reached a plateau, suggesting the need for renewed focus on proper pediatric antimicrobial usage.
There is great variability in the use of antimicrobial medications across countries, with the lowest prescription rates reported in northern European nations, and higher rates in southern Europe and the US. Limited data exist that compare pediatric antibiotic consumption rates across countries, but some studies have suggested that the same global pattern exists.
In the current study, we aimed to investigate the rates of pediatric antibiotic use and compare results across 6 countries, 4 in Europe, 1 in North America, and 1 in Asia.