Trends in antibiotic treatment of acute otitis media and treatment failure in children, 2000-2011.

Guidelines to treat acute otitis media (AOM) were published in 2004. Initial declines in prescribing were shown, but it's unknown if they were sustained. We examine trends in antibiotic dispensing patterns to treat AOM among a large population of children. We also document trends in antibiotic...

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Main Authors: Leah J McGrath, Sylvia Becker-Dreps, Virginia Pate, M Alan Brookhart
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3852237?pdf=render
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author Leah J McGrath
Sylvia Becker-Dreps
Virginia Pate
M Alan Brookhart
author_facet Leah J McGrath
Sylvia Becker-Dreps
Virginia Pate
M Alan Brookhart
author_sort Leah J McGrath
collection DOAJ
description Guidelines to treat acute otitis media (AOM) were published in 2004. Initial declines in prescribing were shown, but it's unknown if they were sustained. We examine trends in antibiotic dispensing patterns to treat AOM among a large population of children. We also document trends in antibiotic failure.Children aged 3 months to 12 years with an AOM diagnosis, enrolled in a commercial claims database between January 1, 2000-December 31, 2011 were included. Pharmacy claims within 7 days of diagnosis were searched for antibiotic prescriptions. Antibiotic failure was defined as a dispensing of a different antibiotic class within 2-18 days after the first prescription. We analyzed trends in antibiotic use and failure by class of antibiotic and year.We identified over 4 million children under 13 years with AOM. The proportion of antibiotic dispensing decreased from 66.0% in 2005 to 51.9% in 2007, after which the instances of dispensing rebounded to pre-guideline levels. However, levels began decreasing again in 2010 and the antibiotic use rate in 2011 was 57.6%. Cephalosporin prescriptions increased by 41.5% over eleven years. Antibiotic failure decreased slightly, and macrolides had the lowest proportion of failures, while all other classes had failure rates around 10%.In recent years, antibiotic dispensing to treat AOM remains high. In addition, the use of broad-spectrum antibiotics is increasing despite having a high rate of treatment failure. Overprescribing of antibiotics and use of non-penicillin therapy for AOM treatment could lead to the development of antibiotic-resistant infections.
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spelling doaj.art-006509b4aff44aa394e51b12ef52eb542022-12-21T21:52:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01812e8121010.1371/journal.pone.0081210Trends in antibiotic treatment of acute otitis media and treatment failure in children, 2000-2011.Leah J McGrathSylvia Becker-DrepsVirginia PateM Alan BrookhartGuidelines to treat acute otitis media (AOM) were published in 2004. Initial declines in prescribing were shown, but it's unknown if they were sustained. We examine trends in antibiotic dispensing patterns to treat AOM among a large population of children. We also document trends in antibiotic failure.Children aged 3 months to 12 years with an AOM diagnosis, enrolled in a commercial claims database between January 1, 2000-December 31, 2011 were included. Pharmacy claims within 7 days of diagnosis were searched for antibiotic prescriptions. Antibiotic failure was defined as a dispensing of a different antibiotic class within 2-18 days after the first prescription. We analyzed trends in antibiotic use and failure by class of antibiotic and year.We identified over 4 million children under 13 years with AOM. The proportion of antibiotic dispensing decreased from 66.0% in 2005 to 51.9% in 2007, after which the instances of dispensing rebounded to pre-guideline levels. However, levels began decreasing again in 2010 and the antibiotic use rate in 2011 was 57.6%. Cephalosporin prescriptions increased by 41.5% over eleven years. Antibiotic failure decreased slightly, and macrolides had the lowest proportion of failures, while all other classes had failure rates around 10%.In recent years, antibiotic dispensing to treat AOM remains high. In addition, the use of broad-spectrum antibiotics is increasing despite having a high rate of treatment failure. Overprescribing of antibiotics and use of non-penicillin therapy for AOM treatment could lead to the development of antibiotic-resistant infections.http://europepmc.org/articles/PMC3852237?pdf=render
spellingShingle Leah J McGrath
Sylvia Becker-Dreps
Virginia Pate
M Alan Brookhart
Trends in antibiotic treatment of acute otitis media and treatment failure in children, 2000-2011.
PLoS ONE
title Trends in antibiotic treatment of acute otitis media and treatment failure in children, 2000-2011.
title_full Trends in antibiotic treatment of acute otitis media and treatment failure in children, 2000-2011.
title_fullStr Trends in antibiotic treatment of acute otitis media and treatment failure in children, 2000-2011.
title_full_unstemmed Trends in antibiotic treatment of acute otitis media and treatment failure in children, 2000-2011.
title_short Trends in antibiotic treatment of acute otitis media and treatment failure in children, 2000-2011.
title_sort trends in antibiotic treatment of acute otitis media and treatment failure in children 2000 2011
url http://europepmc.org/articles/PMC3852237?pdf=render
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