In the Journals

Antibiotics overprescribed, improperly selected to treat pediatric pharyngitis

Recent data show that antibiotics were significantly overprescribed and incorrectly selected to treat pharyngitis in children from 1997 to 2010.

Kathleen L. Dooling, MD, MPH, of the CDC, and colleagues used data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey to assess antibiotic prescribing trends among pediatrics ambulatory care visits for pharyngitis between 1907 and 2010. Children were aged 3 to 17 years.

There were approximately 11,980,000 pediatric visits for pharyngitis each year between 1997 and 2010. Seventy percent of visits occurred in children younger than 12 years.

Sixty percent of pharyngitis visits resulted in antibiotic prescription. Narrow-spectrum penicillins made up 61% of prescribed antibiotics. Prescription of narrow-spectrum penicillins decreased from 65% of antibiotics in 1997 to 52% in 2010. Macrolides increased during the study period.

Twenty-one percent of prescribed antibiotics were macrolides and first-generation cephalosporins. Second- and third-generation cephalosporins and amoxicillin-clavulanate, which are not recommended for pharyngitis treatment, accounted for 18% of prescribed antibiotics.

“There is a gap between observed practice and guideline recommendations for the treatment of pediatric pharyngitis. Multiple strategies, including targeted education and provider audit and feedback, should be used to improve prescribing patterns,” the researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.

Recent data show that antibiotics were significantly overprescribed and incorrectly selected to treat pharyngitis in children from 1997 to 2010.

Kathleen L. Dooling, MD, MPH, of the CDC, and colleagues used data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey to assess antibiotic prescribing trends among pediatrics ambulatory care visits for pharyngitis between 1907 and 2010. Children were aged 3 to 17 years.

There were approximately 11,980,000 pediatric visits for pharyngitis each year between 1997 and 2010. Seventy percent of visits occurred in children younger than 12 years.

Sixty percent of pharyngitis visits resulted in antibiotic prescription. Narrow-spectrum penicillins made up 61% of prescribed antibiotics. Prescription of narrow-spectrum penicillins decreased from 65% of antibiotics in 1997 to 52% in 2010. Macrolides increased during the study period.

Twenty-one percent of prescribed antibiotics were macrolides and first-generation cephalosporins. Second- and third-generation cephalosporins and amoxicillin-clavulanate, which are not recommended for pharyngitis treatment, accounted for 18% of prescribed antibiotics.

“There is a gap between observed practice and guideline recommendations for the treatment of pediatric pharyngitis. Multiple strategies, including targeted education and provider audit and feedback, should be used to improve prescribing patterns,” the researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.

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