Secular trends of antibacterial prescribing in UK paediatric primary care.

ABSTRACT

BACKGROUND: Resistance to antibacterial drugs can be contained by judicious prescribing. In particular, the use of these drugs in children requires ongoing surveillance. While there was a decline in antibacterial prescribing in the UK during the 1990s, recent trends are less well known. OBJECTIVES: To describe antibiotic prescribing patterns and time trends in children in the UK over the last two decades. METHODS: We identified all children ages 0-19 years from 1993 to 2007 and their antibiotic prescriptions from the General Practice Research Database. We used Poisson regression to estimate prescription rates considering the children's age and gender, calendar year and practice. RESULTS: The cohort included 1 751 645 children with 5 835 891 antibacterial prescriptions. The average prescription rate was 511 prescriptions per 1000 person-years [95% confidence interval (CI) 509-513]. As of 1995, the rate decreased to 419/1000 person-years (95% CI 411-426) in 2000, then increased to 568/1000 person-years (95% CI 559-577) in 2007. Between 2000 and 2007, rates increased on average by 4.3% (95% CI 3.7-5.0%) annually, amounting to an increase of 40.7% (95% CI 34.5-47.2%) for all children. Rates were generally higher in girls, except for boys <5 years. Broad-spectrum penicillins were most frequently prescribed; their rate increased on average by 4.6% annually (95% CI 4.0-5.3%) after 2000. This trend was similar in most classes of antibacterials. CONCLUSIONS: Antibacterial prescribing to outpatient children in the UK has been steadily increasing since 2000, consistently for boys and girls, across all ages and antibacterial classes.