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Abstract

Background

Prescribing of systemic antibiotics in general and of cephalosporins in particular in German paediatric outpatients has previously been reported to be higher than in other European countries.

Aim

Our objective was to assess recent trends in antibiotic prescribing in German children.

Methods

This study was conducted as consecutive annual cross-sectional analyses and included all children aged 0–14 years (n = 9,389,183 in 2018) covered by statutory health insurance in Germany. Annual antibiotic prescription rates from 2010 to 2018 were calculated for the age groups 0–1, 2–5, 6–9 and 10–14 years. Poisson regression was used to estimate trends of prescription rates by age group and antibiotic subgroup.

Results

Overall, the age-standardised antibiotic prescription rate decreased significantly by 43% from 746 prescriptions per 1,000 persons in 2010 to 428 per 1,000 in 2018 (p < 0.001). Reductions were most pronounced in the age groups 0–1 year (−50%) and 2–5 years (−44%). The age group 2–5 years exhibited the highest prescription rate with 683 per 1,000 in 2018 (0–1 year: 320/1,000; 6–9 years: 417/1,000; 10–14 years: 273/1,000). Cephalosporins (second and third generation) accounted for 32% of prescribed antibiotics.

Conclusions

Marked reductions in antibiotic prescribing during the last decade indicate a change towards more judicious paediatric prescribing habits. Compared with other European countries, however, prescribing of second- and third-generation cephalosporins remains high in Germany, suggesting frequent first-line use of these substances for common respiratory infections. Considerable regional variations underline the need for regionally targeted interventions.

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2020-08-06
2024-12-22
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Marked reductions in outpatient antibiotic prescriptions for children and adolescents – a population-based study covering 83% of the paediatric population, Germany, 2010 to 2018
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Jakob+Holstiege&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Holstiege Jakob</a>, <a href="/search?value1=Maike+Schulz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schulz Maike</a>, <a href="/search?value1=Manas+K+Akmatov&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Akmatov Manas K</a>, <a href="/search?value1=Annika+Steffen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Steffen Annika</a>, <a href="/search?value1=J%C3%B6rg+B%C3%A4tzing&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bätzing Jörg</a></span>. Marked reductions in outpatient antibiotic prescriptions for children and adolescents – a population-based study covering 83% of the paediatric population, Germany, 2010 to 2018. <a href="/content/ecdc">Euro Surveill.</a> 2020;25(31):pii=1900599. <a href="https://doi.org/10.2807/1560-7917.ES.2020.25.31.1900599" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2020.25.31.1900599</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 26 Sept 2019;&nbsp;&nbsp; <span class="generated">Accepted</span>: 12 Feb 2020 </span> </p>
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