Factors predicting amoxicillin prescribing in primary care among children: a cohort study.
anti-bacterial agents
drug prescriptions
drug resistance
medical record linkage
paediatrics
respiratory tract infections
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
04 Apr 2022
04 Apr 2022
Historique:
received:
16
11
2021
accepted:
30
03
2022
entrez:
11
7
2022
pubmed:
12
7
2022
medline:
12
7
2022
Statut:
aheadofprint
Résumé
Antibiotic prescribing during childhood, most commonly for respiratory tract infections (RTIs), contributes to antimicrobial resistance, which is a major public health concern. To identify factors associated with amoxicillin prescribing and RTI consultation attendance in young children in primary care. Cohort study in Bradford spanning pregnancy to age 24 months, collected 2007-2013, linked to electronic primary care and air pollution data. Amoxicillin prescribing and RTI consultation rates/1000 child-years were calculated. Mixed-effects logistic regression models were fitted with general practice (GP) surgery as the random effect. The amoxicillin prescribing rate among 2493 children was 710/1000 child-years during year 1 (95% confidence interval [CI] = 677 to 744) and 780/1000 (95% CI = 745 to 816) during year 2. During year 1, odds of amoxicillin prescribing were higher for boys (adjusted odds ratio [aOR] 1.36, 95% CI = 1.14 to 1.61), infants from socioeconomically deprived households (aOR 1.36, 95% CI = 1.00 to 1.86), and infants with a Pakistani ethnic background (with mothers born in the UK [aOR 1.44, 95% CI = 1.06 to 1.94] and outside [aOR 1.42, 95% CI = 1.07 to 1.90]). During year 2, odds of amoxicillin prescribing were higher for infants with a Pakistani ethnic background (with mothers born in the UK [aOR 1.46, 95% CI = 1.10 to 1.94] and outside [aOR 1.56, 95% CI = 1.19 to 2.04]) and those born <39 weeks gestation (aOR 1.20, 95% CI = 1.00 to 1.45). Additional risk factors included caesarean delivery, congenital anomalies, overcrowding, birth season, and childcare attendance, with GP surgery explaining 7%-9% of variation. Socioeconomic status and ethnic background were associated with amoxicillin prescribing during childhood. Efforts to reduce RTI spread in household and childcare settings may reduce antibiotic prescribing in primary care.
Sections du résumé
BACKGROUND
BACKGROUND
Antibiotic prescribing during childhood, most commonly for respiratory tract infections (RTIs), contributes to antimicrobial resistance, which is a major public health concern.
AIM
OBJECTIVE
To identify factors associated with amoxicillin prescribing and RTI consultation attendance in young children in primary care.
DESIGN AND SETTING
METHODS
Cohort study in Bradford spanning pregnancy to age 24 months, collected 2007-2013, linked to electronic primary care and air pollution data.
METHOD
METHODS
Amoxicillin prescribing and RTI consultation rates/1000 child-years were calculated. Mixed-effects logistic regression models were fitted with general practice (GP) surgery as the random effect.
RESULTS
RESULTS
The amoxicillin prescribing rate among 2493 children was 710/1000 child-years during year 1 (95% confidence interval [CI] = 677 to 744) and 780/1000 (95% CI = 745 to 816) during year 2. During year 1, odds of amoxicillin prescribing were higher for boys (adjusted odds ratio [aOR] 1.36, 95% CI = 1.14 to 1.61), infants from socioeconomically deprived households (aOR 1.36, 95% CI = 1.00 to 1.86), and infants with a Pakistani ethnic background (with mothers born in the UK [aOR 1.44, 95% CI = 1.06 to 1.94] and outside [aOR 1.42, 95% CI = 1.07 to 1.90]). During year 2, odds of amoxicillin prescribing were higher for infants with a Pakistani ethnic background (with mothers born in the UK [aOR 1.46, 95% CI = 1.10 to 1.94] and outside [aOR 1.56, 95% CI = 1.19 to 2.04]) and those born <39 weeks gestation (aOR 1.20, 95% CI = 1.00 to 1.45). Additional risk factors included caesarean delivery, congenital anomalies, overcrowding, birth season, and childcare attendance, with GP surgery explaining 7%-9% of variation.
CONCLUSION
CONCLUSIONS
Socioeconomic status and ethnic background were associated with amoxicillin prescribing during childhood. Efforts to reduce RTI spread in household and childcare settings may reduce antibiotic prescribing in primary care.
Identifiants
pubmed: 35817584
pii: BJGP.2021.0639
doi: 10.3399/BJGP.2021.0639
pmc: PMC9282803
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Medical Research Council
ID : MR/T016558/1
Pays : United Kingdom
Informations de copyright
© The Authors.
Références
Br J Gen Pract. 2015 Sep;65(638):e585-92
pubmed: 26324495
Inform Prim Care. 2011;19(3):173-82
pubmed: 22688227
Patient Educ Couns. 2005 Feb;56(2):139-46
pubmed: 15653242
JAMA Pediatr. 2014 Nov;168(11):1063-9
pubmed: 25265089
Pharmacoepidemiol Drug Saf. 2009 Aug;18(8):704-7
pubmed: 19455565
J Public Health (Oxf). 2017 Jun 1;39(2):e48-e55
pubmed: 27412173
Environ Health Perspect. 2014 Jan;122(1):107-13
pubmed: 24149084
BMC Pediatr. 2018 Feb 1;18(1):22
pubmed: 29390971
Eur J Pediatr. 2019 Dec;178(12):1867-1874
pubmed: 31493020
Arch Dis Child. 2009 May;94(5):337-40
pubmed: 19066174
J Antimicrob Chemother. 2018 Feb 1;73(suppl_2):ii27-ii35
pubmed: 29490059
Health Place. 2018 Sep;53:10-16
pubmed: 30031949
Clin Exp Allergy. 2021 Nov;51(11):1438-1448
pubmed: 34363720
Cochrane Database Syst Rev. 2007 Oct 17;(4):CD000409
pubmed: 17943742
Euro Surveill. 2019 Jan;24(1):
pubmed: 30621817
BMC Infect Dis. 2017 Mar 21;17(1):220
pubmed: 28320319
BMC Public Health. 2014 Aug 12;14:835
pubmed: 25118003
Br J Gen Pract. 2010 Mar;60(572):e128-36
pubmed: 20202356
Lancet. 2013 Oct 19;382(9901):1350-9
pubmed: 23830354
BMJ. 2021 Nov 1;375:e065927
pubmed: 34725097
J Antimicrob Chemother. 2019 Aug 1;74(8):2440-2450
pubmed: 31038162
Am J Respir Crit Care Med. 2002 Oct 15;166(8):1092-8
pubmed: 12379553
BMJ Open. 2019 Jul 9;9(7):e023989
pubmed: 31289049
BMJ. 2020 Jan 10;368:l6768
pubmed: 31924664
Wellcome Open Res. 2019 Oct 14;4:156
pubmed: 31840089
BMC Fam Pract. 2019 Jul 19;20(1):102
pubmed: 31324157
PLoS One. 2015 Sep 21;10(9):e0138659
pubmed: 26390295
Eur Respir J. 2017 Sep 27;50(3):
pubmed: 28954782
Am J Epidemiol. 2007 Mar 1;165(5):553-60
pubmed: 17158471
J Antimicrob Chemother. 2017 Jun 1;72(6):1818-1824
pubmed: 28333200
BMJ Open. 2014 Oct 27;4(10):e006245
pubmed: 25348424
Int J Epidemiol. 2013 Aug;42(4):978-91
pubmed: 23064411
J Antimicrob Chemother. 2011 Feb;66(2):424-33
pubmed: 21172784
J Antimicrob Chemother. 2014 Dec;69(12):3423-30
pubmed: 25091508
BMJ. 2009 Oct 29;339:b4347
pubmed: 19875845