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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. 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

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  1. Rates and Trends in Antibiotic Prescribing in Irish Children Receiving Free Medical Care Keogh C, Reulbach U, Motterlini N, Bennett K, and Fahey T

  2. 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

  3. 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

  4. 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

  5. Overall rates and trend from 2004-2008

  6. Overall rates and trend from 2004-2008 by gender

  7. Overall rates and trend from 2004-2008 by age

  8. Cost

  9. Choice of agents

  10. 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

  11. Comparison to EU rates

  12. Comparison to EU: Italy and the Netherlands

  13. 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

  14. 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

  15. Antibiotic Prescribing in Irish Children: A Preliminary Analysis Keogh C, Reulbach U, Motterlini N, Bennett K, and Fahey T

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