Journal
JOURNAL OF RURAL HEALTH
Volume 38, Issue 2, Pages 427-432Publisher
WILEY
DOI: 10.1111/jrh.12584
Keywords
antibiotic stewardship; antibiotic use; health services research; Medicaid; rural children
Categories
Funding
- Kentucky Cabinet for Health and Family Services: Department for Medicaid Services, State University Partnership
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The study indicates that female, children under 2 years old, white, and rural children in Kentucky Medicaid have higher rates of antibiotic prescriptions. There is significant geographic variability in prescribing, with children in Eastern Kentucky receiving more than 3 courses of antibiotics a year. Most antibiotic prescriptions for children are written by general practitioners and nurse practitioners rather than pediatricians.
Purpose Antibiotic resistance is a major public health threat. Antibiotic use is the main driver of resistance, with children and the state of Kentucky having particularly high rates of outpatient antibiotic prescribing. The purpose of this study was to describe patient and provider characteristics associated with pediatric antibiotic use in Kentucky Medicaid children. Methods We used Medicaid prescription claims data from 2012 to 2017 to describe patterns of pediatric antibiotic receipt in Kentucky. Patient and provider variables were analyzed to identify variations in prescribing. Findings Children who were female, less than 2 years old, White, and living in a rural area had consistently higher rates of antibiotic prescriptions. There was significant geographic variability in prescribing, with children in Eastern Kentucky receiving more than 3 courses of antibiotics a year. Most antibiotic prescriptions for children were written by general practitioners and nurse practitioners rather than pediatricians. Conclusion These findings support the need for extensive antibiotic stewardship efforts inclusive of rural outpatient practices.
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