Office-Related Antibiotic Prescribing for Medicaid-Enrolled Children

Nett, Randall J.; Campana, David; Custis, Cody L.; Helgerson, Steven D.

doi:10.1177/0009922813479158

Cited by 4 publications

(1 citation statement)

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“…Furthermore, it is also well established that antimicrobial agents are overprescribed by medical professionals, and antihistamines are frequently used inappropriately to treat nonallergic upper respiratory congestion. [27][28][29][30] The largest increase in medication errors was observed for dietary supplements, herbals, and homeopathic agents, the use of which is generally not based on strong scientific evidence. The use of all pharmaceuticals, especially among young children, should be based on the best available medical evidence, 33 To reduce potential dosing errors, manufactures of over-the-counter singleingredient liquid pediatric acetaminophen medications voluntary converted these medications to 1 concentration.…”

Section: Discussionmentioning

confidence: 99%

Out-of-Hospital Medication Errors Among Young Children in the United States, 2002–2012

et al. 2014

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OBJECTIVE: To investigate out-of-hospital medication errors among young children in the United States. METHODS: Using data from the National Poison Database System, a retrospective analysis of out-of-hospital medication errors among children <6 years old from 2002 through 2012 was conducted. RESULTS: During 2002–2012, 696 937 children <6 years experienced out-of-hospital medication errors, averaging 63 358 episodes per year, or 1 child every 8 minutes. The average annual rate of medication errors was 26.42 per 10 000 population. Cough and cold medication errors decreased significantly, whereas the number (42.9% increase) and rate (37.2% increase) of all other medication errors rose significantly during the 11-year study period. The number and rate of medication error events decreased with increasing child age, with children <1 year accounting for 25.2% of episodes. Analgesics (25.2%) were most commonly involved in medication errors, followed by cough and cold preparations (24.6%). Ingestion accounted for 96.2% of events, and 27.0% of medication errors were attributed to inadvertently taking or being given medication twice. Most (93.5%) cases were managed outside of a health care facility; 4.4% were treated and released from a health care facility; 0.4% were admitted to a non–critical care unit; 0.3% were admitted to a critical care unit; and 25 children died. CONCLUSIONS: This is the first comprehensive study to evaluate the epidemiologic characteristics of out-of-hospital medication errors among children <6 years of age on a national level. Increased efforts are needed to prevent medication errors, especially those involving non–cough and cold preparations, among young children.

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Section: Discussionmentioning

confidence: 99%

Out-of-Hospital Medication Errors Among Young Children in the United States, 2002–2012

et al. 2014

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Antibiotic prescribing for children with ARI remains high

2013

PharmacoEcon Outcomes News

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Utilization, Spending, and Price Trends for Quinolones in the US Medicaid Programs: 25 Years’ Experience 1991–2015

Almalki

Yue

Xia

et al. 2016

PharmacoEconomics Open

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BackgroundGiven that the quinolones is one of the antibacterial classes most frequently used to treat patients with bacterial infections in the United States, any change in prescribing patterns of quinolones will impact Medicaid medical expenditures.ObjectivesThis study was undertaken to examine trends in utilization, reimbursement, and prices of quinolone antibacterials for the US Medicaid population.MethodsThe publicly available Medicaid State Drug Utilization outpatient pharmacy files were used for this study. Quarterly and annual prescription counts and reimbursement amounts were calculated for each of the quinolones reimbursed by Medicaid from quarter 1, 1991 through quarter 2, 2015. Average per-prescription reimbursement, as a proxy for drug price, was calculated as the drug reimbursement divided by the number of prescriptions.ResultsThe total annual number of quinolone prescriptions increased 402%, from 247,395 in the first quarter of 1991 to 1.2 million in the second quarter of 2015, peaking at 1.3 million in the first quarter of 2005. Similarly, the total reimbursement for quinolone agents increased by 245.5% over the same period. More than 80% of quinolone prescriptions reimbursed by Medicaid were for the second-generation agent, ciprofloxacin, and the third-generation agent, levofloxacin. The average payment per prescription for quinolones increased from US$43.8 in the first quarter of 1991 to US$87.6 in the second quarter of 2015.ConclusionsA substantial rise in Medicaid expenditures on quinolones was observed during the 25-year study period, which was mainly because of rising utilization. Therefore, there is a need for additional research that has access to clinically relevant data with which to measure the rate of inappropriate quinolone use among the Medicaid population and associated clinical outcomes and healthcare costs.Electronic supplementary materialThe online version of this article (doi:10.1007/s41669-016-0007-y) contains supplementary material, which is available to authorized users.

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Office-Related Antibiotic Prescribing for Medicaid-Enrolled Children

Abstract: The percentage of ARI-related visits linked with an antibiotic prescription did not decrease from 1999 to 2010. Further efforts are needed to reduce antibiotic treatment for ARIs.

Cited by 4 publications

References 22 publications

Out-of-Hospital Medication Errors Among Young Children in the United States, 2002–2012

Out-of-Hospital Medication Errors Among Young Children in the United States, 2002–2012

Antibiotic prescribing for children with ARI remains high

Utilization, Spending, and Price Trends for Quinolones in the US Medicaid Programs: 25 Years’ Experience 1991–2015

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