JAC Advance Access originally published online on January 16, 2004
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Journal of Antimicrobial Chemotherapy (2004) 53, 361-366
© 2004 The British Society for Antimicrobial Chemotherapy
Trends in prescribing antibiotics for children in Dutch general practice
1 Department of General Practice, Ff305, P.O. Box 1738, Erasmus MC, University Medical Center Rotterdam, 3000 DR Rotterdam; 2 NIVEL, Netherlands Institute for Health Services Research; 3 Department of Paediatrics, Erasmus MC, University Medical Center/Sophia Childrens Hospital, Rotterdam, The Netherlands
Received 15 August 2003; returned 13 October 2003; revised 6 November 2003; accepted 8 November 2003
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: antibiotic prescription, children, general practice, cross-sectional study
* Corresponding author. Tel: +31-10-408-9427; Fax: +31-10-463-2127; E-mail: j.otters{at}erasmusmc.nl
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  G. Lusini, F. Lapi, B. Sara, A. Vannacci, A. Mugelli, J. Kragstrup, and L. Bjerrum Antibiotic prescribing in paediatric populations: a comparison between Viareggio, Italy and Funen, Denmark Eur J Public Health, August 1, 2009; 19(4): 434 - 438. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Rosman, M. Le Vaillant, F. Schellevis, P. Clerc, R. Verheij, and N. Pelletier-Fleury Prescribing patterns for upper respiratory tract infections in general practice in France and in the Netherlands Eur J Public Health, June 1, 2008; 18(3): 312 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Sharland and on behalf of the SACAR Paediatric Subgroup The use of antibacterials in children: a report of the Specialist Advisory Committee on Antimicrobial Resistance (SACAR) Paediatric Subgroup J. Antimicrob. Chemother., August 1, 2007; 60(suppl_1): i15 - i26. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Fleming The state of play in the battle against antimicrobial resistance: a general practitioner perspective J. Antimicrob. Chemother., August 1, 2007; 60(suppl_1): i49 - i52. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. S. Blix, A. Engeland, I. Litleskare, and M. Ronning Age- and gender-specific antibacterial prescribing in Norway J. Antimicrob. Chemother., May 1, 2007; 59(5): 971 - 976. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M S van Roosmalen, J C C Braspenning, P A G M De Smet, and R P T M Grol Antibiotic prescribing in primary care: first choice and restrictive prescribing are two different traits Qual. Saf. Health Care, April 1, 2007; 16(2): 105 - 109. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Marra, D. M. Patrick, M. Chong, and W. R. Bowie Antibiotic use among children in British Columbia, Canada J. Antimicrob. Chemother., October 1, 2006; 58(4): 830 - 839. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. I.O. Plasschaert, M. M. Rovers, A. G. M. Schilder, T. J. M. Verheij, and E. Hak Trends in doctor consultations, antibiotic prescription, and specialist referrals for otitis media in children: 1995-2003. Pediatrics, June 1, 2006; 117(6): 1879 - 1886. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Schumann, S. Nutten, D. Donnicola, E. M. Comelli, R. Mansourian, C. Cherbut, I. Corthesy-Theulaz, and C. Garcia-Rodenas Neonatal antibiotic treatment alters gastrointestinal tract developmental gene expression and intestinal barrier transcriptome Physiol Genomics, October 17, 2005; 23(2): 235 - 245. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Akkerman, M. M. Kuyvenhoven, J. C. van der Wouden, and T. J. M. Verheij Analysis of under- and overprescribing of antibiotics in acute otitis media in general practice J. Antimicrob. Chemother., September 1, 2005; 56(3): 569 - 574. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y Takemura, K Ebisawa, H Kakoi, H Saitoh, H Kure, H Ishida, and M Kure Antibiotic selection patterns in acutely febrile new outpatients with or without immediate testing for C reactive protein and leucocyte count J. Clin. Pathol., July 1, 2005; 58(7): 729 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R.A.M.J. Damoiseaux Antibiotic treatment for acute otitis media: time to think again Can. Med. Assoc. J., March 1, 2005; 172(5): 657 - 658. [Full Text] [PDF]
|
|