Antibiotic consumption by New Zealand children: exposure is near universal by the age of 5 years

Hobbs, Mark; Grant, Cameron C.; Ritchie, Stephen; Chelimo, Carol; Morton, Susan; Berry, Sarah D.; Thomas, Mark G.

doi:10.1093/jac/dkx060

Cited by 33 publications

(32 citation statements)

References 32 publications

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“…Our analyses provide results from a single dataset for 75 countries/regions, aiding understanding of overall patterns of antibiotic usage to complement previous national and regional analyses and highlighting differences between high-income and low/middle-income settings, in overall trends and in use of specific antibiotics. Ecological studies such as these provide valuable indications of potential areas for improvements in antibiotic prescribing, but longitudinal, individual-level cohort studies are also needed to give insight into individual-level patterns, determinants and indications for antibiotic use 6 7…”

Section: Discussionmentioning

confidence: 99%

“…While preferences for different types of antibiotics vary between settings,16 37–39 amoxicillin, with or without clavulanic acid, is frequently reported to be one of the most commonly used, particularly in community prescribing 6 36–38 40 41. Although recommended as a first-choice treatment only for specific indications,27 CAFs of amoxicillin with clavulanic acid were sold in volumes similar to those of amoxicillin alone in LMICs.…”

Section: Discussionmentioning

confidence: 99%

“…However, information on the antibiotic formulation may be available and could provide a proxy identifier of drugs dispensed to children, as some oral formulations are particularly suitable for children 5. Quantifying global paediatric antibiotic use is important as childhood exposure to antibiotics in many settings is high; for example, in New Zealand, 97% of children had received at least one course of antibiotics by the age of 5 years 6. Children in low-income settings are also commonly exposed to antibiotics, with an average consumption of 4.9 courses per child-year reported among children aged <2 years in eight low-income settings (Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa and Tanzania), although frequency and patterns of use varied substantially between sites 7.…”

Section: Introductionmentioning

confidence: 99%

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Estimating global trends in total and childhood antibiotic consumption, 2011-2015

Jackson

Hsia

Bielicki³

et al. 2019

BMJ Glob Health

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IntroductionUnderstanding patterns of antibiotic consumption is essential to ensure access to appropriate antibiotics when needed and to minimise overuse, which can lead to antibiotic resistance. We aimed to describe changes in global antibiotic consumption between 2011 and 2015.MethodsWe analysed wholesale data on total antibiotic sales and antibiotics sold as child-appropriate formulations (CAFs), stratified by country income level (low/middle-income and high-income countries (LMICs and HICs)). The volume of antibiotics sold per year was recorded for 36 LMICs and 39 HICs, measured in standard units (SU: 1 SU is equivalent to a single tablet, capsule or 5 mL ampoule/vial/oral suspension) and SU per person, overall and as CAFs. Changes over time were quantified as percentage changes and compound annual growth rates in consumption per person. Analyses were conducted separately for total sales, sales of antibiotics in the Access and Watch groups of the WHO’s Essential Medicines List for children 2017, for amoxicillin and amoxicillin with clavulanic acid.ResultsAntibiotic consumption increased slightly between 2011 and 2015, from 6.85×1010 SU to 7.44×1010 SU overall and from 1.66×1010 SU to 1.78×1010 SU for CAFs. However, trends differed between countries and for specific antibiotics; for example, consumption of amoxicillin as CAFs changed little in LMICs and HICs, but that of amoxicillin with clavulanic acid increased by 6.8% per year in LMICs and decreased by 1.0% per year in HICs.ConclusionsAs measured in standard units in sales data, the rate of increase in global antibiotic consumption may be slowing. However, the trends appear to differ between countries and drugs. In the absence of routine surveillance of antibiotic use in many countries, these data provide important indicators of trends in consumption which should be confirmed in national and local studies of prescribing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Estimating global trends in total and childhood antibiotic consumption, 2011-2015

Jackson

Hsia

Bielicki³

et al. 2019

BMJ Glob Health

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“…Changes in the bacterial microbiome may be implicated in the etiology of CRS . Antibiotic exposure in the early decades of life may contribute significantly to this . Therefore, therapies which even temporarily promote dysbiosis, without contributing to improved long‐term outcomes, may not be helpful.…”

Section: Discussionmentioning

confidence: 99%

The effect of medical treatments on the bacterial microbiome in patients with chronic rhinosinusitis: a pilot study

Jain

Hoggard

Zoing

et al. 2018

Int Forum Allergy Rhinol.

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“…The rate of antibiotic consumption increased by around 49% from 2006 to 2014, with dispensing rates being highest among young children and Pacific peoples [ 7 ]. Data from the Growing up in New Zealand study suggests that most children (97%) have been exposed to antibiotics and received an average of 1.9 antibiotic courses per year by the age of five years [ 8 ]. Antibiotic dispensing was found to be higher among Māori and Pacific children, and children living in the most deprived areas [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Demographic and Psychological Factors Associated with Feelings of Antibiotic Entitlement in New Zealand

et al. 2018

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Patients’ expectations of being prescribed antibiotics can have an important influence on inappropriate prescribing. Therefore, it is important to understand the drivers of patients’ antibiotic expectations. The 2015/16 New Zealand Attitudes and Values Study measured sense of entitlement to antibiotics in a nationally representative sample of New Zealanders (n = 13,484). Participants were asked to rate their agreement with the statement “If I go to my doctor/GP with a minor illness (e.g., sore throat, cough, runny nose, etc.), I think that I should be prescribed antibiotics by default.” Eighty percent of participants showed low feelings of antibiotic entitlement, while 18.5% exhibited moderate and 3.7% high feelings of entitlement. People of ethnic minority, lower socio-economic status, and with diabetes expressed higher expectations of being prescribed antibiotics. This may be partially based on a higher risk of rheumatic fever or other complications. Men, religious people, those with lower educational attainment and self-rated health, but greater psychological distress and feelings of control over their health exhibited higher feelings of antibiotic entitlement. Those high on Extraversion, Conscientiousness, and Narcissism, but low on Agreeableness and Openness, also showed greater feelings of entitlement. Our findings help identify key characteristics of those more likely to express inappropriate expectations of antibiotic prescription.

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Antibiotic consumption by New Zealand children: exposure is near universal by the age of 5 years

Cited by 33 publications

References 32 publications

Estimating global trends in total and childhood antibiotic consumption, 2011-2015

Estimating global trends in total and childhood antibiotic consumption, 2011-2015

The effect of medical treatments on the bacterial microbiome in patients with chronic rhinosinusitis: a pilot study

Demographic and Psychological Factors Associated with Feelings of Antibiotic Entitlement in New Zealand

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