Drop in antibiotic use fuels decline in prescriptions for kids

Efforts by doctors and public health experts to rein in the use of antibiotics in children appear to be working, according to a new study that shows a 14% decline in pediatric prescriptions for those drugs between 2002 and 2010.

As many as half of the antibiotics taken in this country are taken inappropriately – to treat infections caused by viruses instead of bacteria, for example. In these cases, the drugs don’t help patients, but they do help bacteria build resistance to the drugs.

An analysis of prescription data from two large companies that track retail pharmacy sales found that the drop in antibiotic use fueled an overall decline in prescription drug use among children and teens. The analysis was conducted by researchers at the Food and Drug Administration and published online this week by the journal Pediatrics.

Altogether, 263 million pediatric prescriptions were filled in 2010, which represents a 7% reduction compared to 2002. (For the sake of comparison, prescriptions for adults increased by 22% over the same period.) When population size was taken into account, total prescriptions for kids fell by 9% over the eight-year period.

Still, the most-prescribed drug for pediatric patients was the workhorse antibiotic amoxicillin. Nearly 18.3 million patients received at least one prescription for that drug in 2010, according to the analysis. Coming in second with nearly 10.2 million patients was another antibiotic, azithromycin.

The FDA researchers identified 30 drugs that were prescribed to at least 1 million patients in 2010. But more than 1,700 medications were given to fewer than 10,000 patients that year.

Other trends noted in the study include:

• Prescriptions for cough and cold medications without expectorant fell by 42% between 2002 and 2010. Most of that decrease came after 2008, when the FDA published an advisory about these drugs and recommended against their use in children under the age of 2.
• The number of prescriptions filled to treat allergies fell by 61% in the eight-year period. That was the largest percentage decline of any category studied. Pediatric prescriptions also fell by 14% for pain meds and 5% for antidepressants.
• The number of birth control prescriptions filled for teens nearly doubled between 2002 and 2010. But the FDA researchers noted that surveys by the Centers for Disease Control and Prevention have not found an increase in the number of young women who said they were taking birth control medications, so the study authors suggested that more teens might be taking the pills for other reasons, such as acne treatment.
• Prescriptions for attention deficit hyperactivity disorder (ADHD) drugs rose 42% in the study period. That increase came as the number of children identified as having ADHD rose from 4.4 million to 5 million. The increase in prescriptions was driven by use of newer ADHD drugs, including Vyvance (lisdexamfetamine), Focalin (dexmethylphenidate) and Tenex/Intuniv (guanfacine).

The study is online here.

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