4.4 Article

Narrow- and Broad-Spectrum Antibiotic Use among US Children

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HEALTH SERVICES RESEARCH
卷 50, 期 3, 页码 830-846

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WILEY-BLACKWELL
DOI: 10.1111/1475-6773.12260

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Children; antibiotics; narrow- and broad-spectrum; multinomial choice model

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ObjectivesTo provide updated estimates of narrow- and broad-spectrum antibiotic use among U.S. children. Data SourcesLinked nationally representative data from the 2004-2010 Medical Expenditure Panel Survey Household Component and the 2000 Decennial Census. Study DesignRelationships between individual-, family-, and community-level characteristics and the use of antibiotics overall and in the treatment of respiratory tract infections (RTIs) are examined using multinomial choice models. Principal FindingsMore than one quarter (27.3 percent) of children used at least one antibiotic each year with 12.8 percent using broad-spectrum and 18.5 percent using narrow-spectrum antibiotics. Among children with use, more than two-thirds (68.6 percent) used antibiotics to treat RTIs. Multivariate models revealed many differences across groups in antibiotic use, overall and in the treatment of RTIs. Differential use was associated with a broad range of factors related to need (e.g., age, health status), resources (e.g., insurance status, parental income, and education), race-ethnicity, and Census region. ConclusionsDespite encouraging reports regarding the declining use of antibiotics, large differences in use associated with resources, race-ethnicity, and Census regions suggest a need for further improvement in the judicious and appropriate prescribing of antibiotics for U.S. children.

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