Max Xie (Canada)
British Columbia Centre for Disease Control Communicable Disease and Immunization ServicesAuthor Of 1 Presentation
DURATION OF ANTIBIOTIC PRESCRIPTION AMONG YOUNG CHILDREN IN BRITISH COLUMBIA (BC), CANADA: ROOM FOR IMPROVEMENT
Abstract
Backgrounds:
Antibiotic overuse, including unnecessary prescription as well as longer than necessary duration of therapy (DOT), contributes to antibiotic resistance. This study examined the DOT for common infections among children <10 years in BC, Canada.
Methods
In this population-based, retrospective cohort study, prescription and physician billing data generated during 2019 were anonymously linked to determine prescriptions associated with specific diagnoses for children < 10 years of age. These included community acquired pneumonia (CAP), acute otitis media (AOM), cystitis, acute bronchitis, pyelonephritis, and cellulitis. The linked data accounts for >85% community prescriptions with the remainder contributed by other professions who do not use the physician billing system. Median (Q1; first quartile, Q3; third quartile) DOT were examined for the study population, across select diagnoses and stratified by age (<1, 1–4 and 5–9), gender and antibiotic class.
Results:
In 2019, the overall median (Q1, Q2) DOT, as well as for diagnoses of interest was 7 (7, 10) days. However, the DOT distribution skewed further right for AOM, cellulitis, cystitis and acute bronchitis. Median (Q1, Q3) DOT was 7 (7, 7) days for CAP, 7 (6, 7) days for cystitis, and 7 (7, 10) days for pyelonephritis, acute bronchitis, and suppurative and non-suppurative otitis media. Each DOT distribution was also informed by which antibiotic was used (see figure). For CAP and acute bronchitis, azithromycin was mostly prescribed for 5 days, whereas 26.9% amoxicillin was prescribed for ≥10 days. 84.6%amoxicillin prescribed for otitis media (suppurative and nonsuppurative) among children 5-9 years was ≥ 7 days.
Conclusions/Learning Points:
Antibiotic DOT in children for many indications was longer than current guidelines. Opportunities are present to further reduce unnecessary antibiotic exposure by emphasizing shorter DOT where evidence supports equivalent outcomes.