Antibiotics Overprescribed for Pediatric Pharyngitis

Article

A research letter published in JAMA Pediatrics uncovered a gap between observed practice and guideline recommendations in medication prescribing for pediatric pharyngitis.

A research letter published in JAMA Pediatrics uncovered a gap between observed practice and guideline recommendations in medication prescribing for pediatric pharyngitis.

A multifaceted team of researchers examined data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, which are 2 nationally representative samples of ambulatory care practices. They included data from pharyngitis patients aged 3 to 17 years between January 1, 1997, and December 31, 2010.

Of those subjects, 462 had acute pharyngitis, 463 had acute tonsillitis, and 34 had streptococcal sore throat and scarlet fever. Ambulance patients were excluded if they had concomitant infection that warranted other antibiotic therapy.

Between 1997 and 2010, there were approximately 12 million pediatric visits for pharyngitis, or about 198 related visits per 1000 children. During more than half of the visits (60%), antibiotics were prescribed, and 61% of those prescriptions were for narrow-spectrum penicillin. However, such prescribing decreased from 65% of antibiotics in 1997 to 1998, to 52% in 2009 to 2010, while prescriptions for broader-spectrum antibiotics increased.

Macrolides and first-generation cephalosporins—which are second-line antibiotics for group A Streptococcus (GAS) pharyngitis—accounted for 21% of antibiotics prescribed, while second- and third- generation cephalosporins and amoxicillin-clavulanate, which are not recommended, comprised 18%.

“Despite the release of multiple clinical guidelines recommending narrow-spectrum penicillins for first-line treatment of GAS pharyngitis, their use did not increase,” the authors concluded. “…Similar to previous findings in adults and children, narrow-spectrum penicillins are underprescribed in favor of broader-spectrum antibiotics, especially macrolides and cephalosporins.”

The researchers noted their study was limited by the unknown amount of GAS testing and prevalence of penicillin, and continued follow-up is necessary to verify the apparent negative trend in penicillin prescribing.

Related Videos
Laboratory test tubes and solution with stethoscope background | Image Credit: Shutter2U - stock.adobe.com
Image credit: Andrea Izzotti
Inflation Reduction Act is shown using the text and the US flag - Image credit: Andrii | stock.adobe.com
Pharmacy Interior | Image Credit: Tyler Olson - stock.adobe.com
Male pharmacist selling medications at drugstore to a senior woman customer | Image Credit: Zamrznuti tonovi - stock.adobe.com
Pharmacist assists senior woman in buying medicine in pharmacy - Image credit: Drazen | stock.adobe.com
Pharmacy, medicine and senior woman consulting pharmacist on prescription. Healthcare, shopping and elderly female in consultation with medical worker for medication box, pills or product in store - Image credit: C Daniels/peopleimages.com | stock.adobe.com
Image credit: fidaolga - stock.adobe.com
Pharmacists checking inventory at hospital pharmacy- Image credit: Jacob Lund | stock.adobe.com
Young male pharmacist giving prescription medications to senior female customer in a pharmacy | Image Credit: Zamrznuti tonovi - stock.adobe.com
© 2023 MJH Life Sciences

All rights reserved.