Journal Article

Trends in prescribing antibiotics for children in Dutch general practice

Hanneke B. M. Otters, Johannes C. van der Wouden, Francois G. Schellevis, Lisette W. A. van Suijlekom-Smit and Bart W. Koes

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 53, issue 2, pages 361-366
Published in print February 2004 | ISSN: 0305-7453
Published online February 2004 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dkh062
Trends in prescribing antibiotics for children in Dutch general practice

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  • Medical Oncology
  • Critical Care

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Objective: To assess changes in antibiotic prescribing patterns for children between 1987 and 2001, and to identify general practice characteristics associated with higher antibiotic prescribing rates.

Methods: Cross-sectional national survey of Dutch general practice in 1987 and 2001. Data were used for all children aged 0–17 years; 86 577 children in 103 participating practices in 1987, and 76 010 children in 90 participating practices in 2001. Population-based, contact-based and disease-based antibiotic prescription rates were evaluated by age, gender and diagnosis. Practice characteristics associated with inappropriate broad-spectrum antibiotic prescription were identified.

Results: Population-based prescription rates decreased from 300/1000 children (95% CI, 292–307) in 1987 to 232/1000 children in 2001 (95% CI, 228–235). In 1987, the contact-based prescription rate was 108/1000 contacts (95% CI, 106–111) and this was somewhat similar in 2001: 103/1000 contacts (95% CI, 101–105). In 2001, increased disease-based prescription rates were observed for acute otitis media, acute bronchitis, acute upper airway infections, acute tonsillitis and cough. Overall, non-recommended broad-spectrum antibiotics were prescribed more often in 2001 than in 1987 (87% in 1987 versus 90% in 2001, P < 0.001). Adjusted for other practice characteristics, general practitioners in single-handed practices prescribed 58% more broad-spectrum antibiotics inappropriately for upper airway infections than general practitioners in group practices.

Conclusion: Antibiotic prescribing in children is still relatively low in the Netherlands. However, the prescription of broad-spectrum antibiotics for inappropriate diagnoses has increased, an unfavourable trend given the emerging bacterial resistance. Single-handed practices should especially be targeted to improve antibiotic prescribing in children.

Keywords: Keywords: antibiotic prescription, children, general practice, cross-sectional study

Journal Article.  4209 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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