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Rates and Trends in Antibiotic Prescribing in Irish Children Receiving Free Medical Care. Keogh C, Reulbach U, Motterlini N, Bennett K, and Fahey T. Introduction. Antibiotics are the most commonly prescribed drug in paediatric populations

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rates and trends in antibiotic prescribing in irish children receiving free medical care

Rates and Trends in Antibiotic Prescribing in Irish Children Receiving Free Medical Care

Keogh C, Reulbach U, Motterlini N, Bennett K, and Fahey T

introduction
Introduction
  • Antibiotics are the most commonly prescribed drug in paediatric populations
  • Concern is growing worldwide over rates of antibiotic prescribing
  • Limited research exists on prescribing trends in paediatric populations
    • Quality of prescribing
    • Rates and trends in prescribing
slide3
Aim
  • Antibiotic prescribing behaviour in an Irish paediatric population
    • Overall rates and trend from 2004-2008
    • Cost
    • Choice of agents
    • Comparison to European prescribing behaviour
methods
Methods
  • Data was obtained from the General Medical Services (GMS) claims database
    • routinely collected dispensing data
    • patients receiving free medical care (means-tested)
    • represents about one-third of all Irish children
    • Socially disadvantaged are over-represented
  • Systemic antibiotics (ATC code J01) 2004-2008
    • About 270,000 children per year
    • Age (0-4, 5-11 and 12-15) and gender  
    • Net ingredient cost of drugs
  • Calculated prevalence per 1000 GMS population
choice of agents1
Choice of agents
  • Tetracycline
    • contra-indicated for children under 12, due to potential damage to teeth and bones and may result in bone growth retardation
    • GMS data (0-11 age group):3/100,000 population
  • Ciprofloxacin
    • Ciprofloxacin is not recommended as a first line agent (linked to arthropathy)
    • GMS data (0-4 age group) 17/100,000 population
summary
Summary
  • Overall rate of prescribing has remained relatively stable
    • No differences observed between males and females
    • Differences between age groups as expected
  • Cost of antibiotic prescribing increased
  • Preferred choice of agents changed
  • Higher prevalence than EU comparisons
    • Choice of agent similar but different prescription rates
discussion
Discussion
  • GMS data represents lower socioeconomic status groups. This may result in an over-inflation of prescription rates
  • Lack of diagnostic information makes quality of prescribing difficult in this context
  • There remains limited country specific and age specific data for paediatric populations
    • Wide heterogeneity across studies
  • Research on quality of care for children may inform starting points for improved antibiotic prescribing in this population
antibiotic prescribing in irish children a preliminary analysis

Antibiotic Prescribing in Irish Children: A Preliminary Analysis

Keogh C, Reulbach U, Motterlini N, Bennett K, and Fahey T