Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Trends in Pediatric Outpatient Antibiotic Use

Pediatrics; ePub 2018 Dec 17; Finkelstein, et al

In an analysis of data from 3 health plans, there was a substantial decline in pediatric outpatient antibiotic use between 2010 to 2014, with prescribing decreased for diagnoses for which antibiotic were clearly not indicated. Researchers calculated population-based antibiotic-dispensing rates from the same health plans for each study year between 2000 and 2014. For each health plan and age group, Poisson regression models allowed 2 reflection points. The change in dispensing rates in the periods before the first inflection point, between the first and second inflection points, and after the second inflection point, were calculated. Among the findings:

  • There was a dramatic decrease in antibiotic dispensing over the 14 study years.
  • There were substantial decreases between 2010 and 2014, despite previous evidence of a plateau in rates.
  • The fraction of prescribing associated with individual diagnoses was relatively stable.
  • Prescribing for diagnoses for which antibiotics are clearly not indicated decreased.


Finkelstein JA, Raebel MA, Nordin JD, Lakoma M, Young JG. Trends in outpatient antibiotic use in 3 health plans. [Published online ahead of print December 17, 2018]. Pediatrics. doi:10.1542/peds.2018-1259.

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