To evaluate antibiotic use in children younger than 18 years in ambulatory care settings, researchers analyzed data from the 2006 through 2008 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. Health care providers prescribed antibiotics at 21% (approximately 49 million) of the ambulatory care visits made by children each year of the study.

The most commonly prescribed classes of antibiotics were narrow-spectrum penicillins (38% of visits at which antibiotics were prescribed), followed by macrolides (20% of visits at which antibiotics were prescribed). Broad-spectrum antibiotics were given at 50% of all visits at which antibiotics were prescribed. The most commonly prescribed antibiotics in the broad-spectrum category were macrolides, broad-spectrum cephalosporins, and broad-spectrum penicillins.

Antibiotics were most often prescribed for respiratory conditions (73% of visits at which antibiotics were prescribed), and although 49% of antibiotics were prescribed for acute respiratory tract infections for which antibiotics are recommended, 12% were prescribed for respiratory conditions for which antibiotics may be unnecessary. Overall, antibiotics may have been inappropriately prescribed for respiratory infections at more than 10 million visits annually; this included more than 6 million visits in which broad-spectrum antibiotics were given.

Additional analyses showed that broad-spectrum antibiotics were more likely than other antibiotics to be prescribed for respiratory conditions for which antibiotic treatment is not indicated. In addition, children younger than six years were more likely to be given a broad-spectrum antibiotic than those ages six to 12 years. Also, patients with private insurance received broad-spectrum antibiotics more often than those with public or no insurance.-SDSJ

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