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Trends in Antibiotic Treatment of Acute Otitis Media and Treatment Failure in Children, 2000–2011

OBJECTIVES: 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...

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Autores principales: McGrath, Leah J., Becker-Dreps, Sylvia, Pate, Virginia, Brookhart, M. Alan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3852237/
https://www.ncbi.nlm.nih.gov/pubmed/24324680
http://dx.doi.org/10.1371/journal.pone.0081210
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author McGrath, Leah J.
Becker-Dreps, Sylvia
Pate, Virginia
Brookhart, M. Alan
author_facet McGrath, Leah J.
Becker-Dreps, Sylvia
Pate, Virginia
Brookhart, M. Alan
author_sort McGrath, Leah J.
collection PubMed
description OBJECTIVES: 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. STUDY DESIGN: 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. RESULTS: 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%. CONCLUSIONS: 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 pubmed-38522372013-12-09 Trends in Antibiotic Treatment of Acute Otitis Media and Treatment Failure in Children, 2000–2011 McGrath, Leah J. Becker-Dreps, Sylvia Pate, Virginia Brookhart, M. Alan PLoS One Research Article OBJECTIVES: 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. STUDY DESIGN: 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. RESULTS: 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%. CONCLUSIONS: 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. Public Library of Science 2013-12-04 /pmc/articles/PMC3852237/ /pubmed/24324680 http://dx.doi.org/10.1371/journal.pone.0081210 Text en © 2013 McGrath et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
McGrath, Leah J.
Becker-Dreps, Sylvia
Pate, Virginia
Brookhart, M. Alan
Trends in Antibiotic Treatment of Acute Otitis Media and Treatment Failure in Children, 2000–2011
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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3852237/
https://www.ncbi.nlm.nih.gov/pubmed/24324680
http://dx.doi.org/10.1371/journal.pone.0081210
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