Antibiotic usage, dosage and course length in children between 0 and 4 years

Acta Paediatr. 2009 Jul;98(7):1142-8. doi: 10.1111/j.1651-2227.2009.01309.x. Epub 2009 Apr 21.

Abstract

Aim: Antibiotic drugs are most frequently used by 0- to 4-year-old children. We performed a cross-sectional study in the Netherlands using a pharmacy prescription database to investigate the use, dose and course length of antibiotic drugs in 0- to 4-year-olds.

Methods: We used a database with pharmacy drug-dispensing data. We investigated all prescriptions of systemic antibiotics prescribed in the years 2002-2006 for children of 0-4 years of age. Prescriptions for children under the age of 3 months were excluded.

Results: Children of 9-12 months of age received more antibiotics than children in other age groups. In the 3- to 6-month-olds, amoxicillin was prescribed in 75.2% of the cases. This percentage was 50.4% in the 4-year-olds. The contribution of other broad-spectrum antibiotics increased with age (clarithromycin and amoxicillin/clavulanic acid). Small-spectrum penicillins were prescribed less often than the broad-spectrum antibiotics. From the prescriptions of the five most used drugs, 97.6% were within the recommended dose range. Most course lengths corresponded with the guidelines. Of the prescriptions, 3.9% were unlicensed or off-label.

Conclusion: Within the group of 0- to 4-year-old children, most antibiotics were used by 9- to 12-month-olds. The doses and course lengths were mostly correct, but the choice of antibiotics was not according to the guidelines. Young children received unlicensed and off-label prescribed antibiotics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Anti-Bacterial Agents / administration & dosage*
  • Child, Preschool
  • Cross-Sectional Studies
  • Drug Approval
  • Drug Prescriptions / statistics & numerical data
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Infant
  • Male
  • Netherlands
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*

Substances

  • Anti-Bacterial Agents