Antibiotic misuse in children still a concern in the US

Children in the US are still being incorrectly and over-prescribed antibiotics, new research has shown.

Published in the Journal of the Pediatric Infectious Diseases Society, the study showed that children under 2 years of age in US emergency departments are regularly prescribed antibiotics to treat bronchiolitis, a common viral lung infection in the young.

The news comes despite the American Academy of Pediatrics (AAP) guideline’s advice not to routinely use antibiotics in children with the disease, as it carries an extremely low risk (below 1%) of causing any bacterial infection.

The study authors analysed data collected by the National Hospital Ambulatory Medical Care Survey (NAHAMCS), an annual survey conducted on approximately 30,000 visits to emergency departments in 300 randomly selected hospitals. In particular, they looked at children under 2 years with a discharge diagnosis of bronchiolitis between 2007 and 2015.

They found that around 26% of children under 2 years who visited emergency departments received antibiotics as part of their treatment for bronchiolitis. No significant change was reported in the proportion of patients who received antibiotics during the study period, following the publication of the AAP guidelines.

The study also shows that of the children who received antibiotics, almost 70% did not suffer from a bacterial infection.

Furthermore, macrolides were found to be frequently prescribed. These antibiotics aren’t commonly indicated for use in children below 2 years due to their potential to cause bacterial resistance and adverse effects.

Taken together, these results seem to suggest that antibiotic over-prescription and misuse is still a problem in US emergency departments.

Over- and incorrect prescription of antibiotics is a significant contributor to antibiotic resistance, as it can encourage the growth of bacterial strains which aren’t affected by the drugs we rely on to kill them.

“Targeted interventions to reduce inappropriate prescribing among clinicians are essential,” said Dr Brett Burnstein, senior author of the study. “At the same time, informing the lay public about the potential downstream consequences and why it is important not to over-treat viral conditions are equally important.”

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