Recurrent Antibiotic Prescriptions in the Kentucky Medicaid Population

BACKGROUND: Kentucky (KY) has the second highest prescription rate of antibiotics in the US. Prior studies based on anonymous pharmacy claims have been unable to determine whether this high rate is attributable to prescribing to a greater proportion of the population as compared with other states or to recurrent antibiotic use in a more limited group of children. We identified children with multiple antibiotic courses in a longitudinal cohort of children enrolled by KY Medicaid. METHODS: We reviewed pharmacy claims of children (age <20) covered by KY Medicaid from 10/1/2015 to 9/30/2016. Systemic antibacterials were identified using specific National Drug Codes. Sociodemographic characteristics of interest included age, sex, race and Medicaid region. Descriptive statistics were used to identify patient characteristics associated with recurrent courses of antibiotics. Linear regression was used to determine factors independently associated with the number of courses prescribed in a calendar year. RESULTS: 333, 965 children received 778,471 antibiotic prescriptions across the year (Median 2, IQR 1–3). Summary statistics for recurrent courses of antibiotics by sociodemographic characteristics are presented in the Table. CONCLUSION: Children enrolled in KY Medicaid received, on average, 2 antibiotic prescriptions a year. Geographic variability in the number of prescriptions persisted after adjusting for sociodemographic characteristics. This suggests there may be modifiable prescribing behaviors among practitioners across the state. Further research into parental and provider perceptions of antibiotics are needed, and should focus on region 8. DISCLOSURES: All authors: No reported disclosures.