Coprescription of Antibiotics and Asthma Drugs in Children

Abstract

WHAT THIS STUDY ADDS:In this study, antibiotic use was found to be 1.9 times more frequent in children who were treated with asthma drugs than those who were not. Among children who received an asthma drug, 35.6% were dispensed an antibiotic on the same day. abstract BACKGROUND: In children, antibiotics as well as asthma drugs are frequently prescribed. We investigated the effects of the codispensing of antibiotics and asthma drugs to children. METHODS:Using a health insurance database, we examined dispensing and codispensing of antibiotics and asthma drugs for the period of a 1 year in 892 841 Belgian children aged Ͻ18 years. RESULTS:For a 1-year period, an antibiotic was dispensed to 44.21% of children: 73.05% aged Ͻ3 years; 49.62% aged 3 to 7 years; and 34.21% aged 8 to Ͻ18 years. An asthma drug was dispensed to 16.04% of children: 44.81% aged Ͻ3 years; 17.90% aged 3 to 7 years; and 7.64% aged 8 to Ͻ18 years. Overall, an antibiotic was dispensed without an asthma drug to 38.62% of children versus with an asthma drug to 73.50% of children (P Ͻ .0001). More frequent dispensing of antibiotics to children who received an asthma drug (odds ratio: 1.90; 95% confidence interval: 1.89 -1.91) occurred in all age categories (P Ͻ .0001). In 35.64% of children with an asthma drug dispensed, an antibiotic was dispensed on the same day. CONCLUSIONS:In all age groups, dispensing of antibiotics is more likely in children who have an asthma drug dispensed in the same year. In all age groups, codispensing of antibiotics and asthma drugs is a common practice. Efforts to decrease antibiotic use in children could be improved by focusing on children who are being treated with asthma drugs.

Population-Based Cohort Study of Anti-Infective Medication Use before and after the Onset of Type 1 Diabetes in Children and Adolescents

“…The observed differences in the prevalence and average number of anti-infective prescriptions between different sex and age categories in both cohorts are in line with the results of other studies (20)(21)(22). In our study, the highest prevalence for antiinfective prescriptions was observed for boys who developed type 1 diabetes at the age of 0 to 4 years.…”

Early-life antibiotic use is associated with wheezing among children with high atopic risk: a prospective European study

“…De Boeck et al used a health insurance database that encompassed the records from 892 841 Belgian children seen in 1 year to examine antibiotic-prescribing practices. They reported that 36.62% of the children without an asthma medication received an antibiotic while 73.50% children with an asthma medication did so [35]. Stallworth et al [36] reported that pediatric asthmatic patients received significantly more antibiotic prescriptions than non-asthmatics for conditions caused by bacteria as well as for conditions more likely to be viral in origin.…”

“…Furthermore, Jedrychowski et al [38] conducted a birth cohort with 310 Polish children and found that the overall use of antibiotics during early childhood was insignificantly associated with asthma (OR ¼ 1.65, 95% CI: 0.93-2.93), although the crude OR was significant (OR ¼ 2.14, 95% CI: 1.37-3.34). There have been several additional reports of asthma associated with clinical antibiotic exposures in the literature [30][31][32][33][34][35]. One such study found an extremely elevated prevalence of asthma in children with high exposures to clinical antibiotics in the first three years of life, especially in those with nonatopic asthma [30].…”

Antibiotic Prescription With Asthma Medications: Why Is It So Common?

“…6,7 De Boeck et al 6 used a health insurance database that encompassed the records of 892 841 Belgian children seen in 1 year to examine antibiotic-prescribing practices. During this period, an antibiotic was dispensed to 44.21% of the children covered by this insurance provider, and an asthma drug (␤-adrenergic agents, inhaled corticosteroid, ipratropium, and/or leukotriene receptor antagonist) was dispensed to 16.04%.…”

“…De Boeck et al 6 had access to data from a health care insurer that covers 44% of the population of Belgium, where medical insurance coverage is mandatory. Although neither study directly assessed the complaints and findings that led to prescription of either antibiotic or bronchodilator therapy, the results suggest that Belgian and American physicians prescribe antibiotics for patients perceived to have a diagnosis of asthma or bronchospasm at a previously unsuspected level: as often as 1 in 6 visits for American children, which accounts for 1 million or more dubious prescriptions per year.…”