In a study using national claims data for more than 73 million pediatric visits from the NIH Collaboratory’s Distributed Research Network, researchers found uneven declines in potentially inappropriate antibiotic dispensing between 2006 and 2016. The findings suggest a need for antibiotic stewardship programs, especially interventions focusing on the use of broad-spectrum antibiotics in outpatient settings.

The study was published this week in Pharmacology Research & Perspectives.

Although overall antibiotic prescribing among children in outpatient settings has declined since the mid-1990s, recent evidence suggests the trend may be ending. Also, it is unknown whether antibiotic stewardship efforts have influenced prescribing trends in emergency department settings.

In the new study, which included children and adolescents aged 3 months to 18 years, there was a 5% annual decrease in antibiotic prescribing in emergency departments for respiratory tract infections for which antibiotics are mostly not or never indicated. The annual decline in outpatient settings was 2%. For broad-spectrum antibiotics for respiratory tract infections for which antibiotics are mostly indicated, there were annual declines of 2% to 4% in emergency department settings, compared with an annual increase of 1% in outpatient settings. Dispensing rates were consistently higher among children younger than 12 years than among adolescents.

This work was supported by a grant from the National Center for Complementary and Integrative Health. Support was also provided within the NIH Collaboratory by the NIH Common Fund through a cooperative agreement from the Office of Strategic Coordination within the Office of the NIH Director. Learn more about the NIH Collaboratory Distributed Research Network.