Antibiotics are the most prescribed drugs in children in Europe. The aim was to evaluate the out-of-hospital prescription of antibiotics in children aged 0–4 years with acute upper respiratory tract infections (URTI) in a Spanish Health Area during the period 2014–2023, as well as to analyze the differences according to age and health care setting. Retrospective study with data obtained from the Primary Care Information System of the Castilla-La Mancha Public Health Service (SESCAM). They correspond to a health area composed of 23 basic health zones and 69 municipalities. The variables selected included age, sex, diagnoses, setting (rural or urban), year of prescription, and antibiotics prescribed. A total of. 120,868 antibiotics were prescribed, with a rate of antibiotic prescription during this period (pPR) in children aged 0–4 years with URTI of 688.1 prescriptions/1000 persons/year. Children aged 12–35 months had the highest pPR (851.5). The pPR in rural areas was higher than in urban areas in all the pathologies studied: tonsillitis (486.3 versus 321.5), otitis (262.2 versus 203.7), and nasopharyngitis (96.2 versus 58.6). Amoxicillin was the most commonly used antibiotic (pPR 400.5). In urban areas, the prescription of beta-lactamase sensitive penicillins was significantly higher than in rural areas (p < 0.05) and significantly lower for amoxicillin (p < 0.05), amoxicillin/clavulanic acid (p < 0.01), and azithromycin (p < 0.01).Conclusions: Children aged 12–35 months received most of the antibiotic prescriptions, especially in rural areas. In urban areas, fewer and narrower-spectrum antibiotics are prescribed, with a lower use of amoxicillin/clavulanic acid and azithromycin.<Table Float="No" ID="Taba"> <tgroup cols="1"> <colspec align="left" colname="c1" colnum="1" /> <tbody> <row> <entry align="left" colname="c1"> What is Known? • Antibiotics are the most commonly prescribed drugs in the pediatric population throughout Europe, with children aged 0-4 years, along with the population over 75 years of age, being the age groups where antibiotics are mostly used. • Upper respiratory tract infections and acute otitis media are the most common diseases for which antibiotics are prescribed. </entry> </row> <row> <entry align="left" colname="c1"> What is New? • In recent years, antibiotic prescription rates in children have decreased and the quality of prescriptions has improved, with fewer prescriptions of amoxicillin/clavulanic acid and azithromycin and an increased use of penicillin and amoxicillin. • Antibiotic prescription rates in children are higher in rural areas than in urban areas, with a greater tendency to use broad-spectrum antibiotics in the former. </entry> </row> </tbody> </tgroup> </Table>

Analysis of antibiotic prescription in upper respiratory tract infections in children 0-4 years of age in primary care. Impact of age and health care setting

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2025年11月1日

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Carlos Marcilla Vázquez,
María Jesús Dabad Moreno,
Juan Ríos Laorden,
Ángeles Lloret Callejo,
Francisco Tejada Cifuentes,
Ignacio Párraga-Martínez

摘要

Antibiotics are the most prescribed drugs in children in Europe. The aim was to evaluate the out-of-hospital prescription of antibiotics in children aged 0–4 years with acute upper respiratory tract infections (URTI) in a Spanish Health Area during the period 2014–2023, as well as to analyze the differences according to age and health care setting. Retrospective study with data obtained from the Primary Care Information System of the Castilla-La Mancha Public Health Service (SESCAM). They correspond to a health area composed of 23 basic health zones and 69 municipalities. The variables selected included age, sex, diagnoses, setting (rural or urban), year of prescription, and antibiotics prescribed. A total of. 120,868 antibiotics were prescribed, with a rate of antibiotic prescription during this period (pPR) in children aged 0–4 years with URTI of 688.1 prescriptions/1000 persons/year. Children aged 12–35 months had the highest pPR (851.5). The pPR in rural areas was higher than in urban areas in all the pathologies studied: tonsillitis (486.3 versus 321.5), otitis (262.2 versus 203.7), and nasopharyngitis (96.2 versus 58.6). Amoxicillin was the most commonly used antibiotic (pPR 400.5). In urban areas, the prescription of beta-lactamase sensitive penicillins was significantly higher than in rural areas (p < 0.05) and significantly lower for amoxicillin (p < 0.05), amoxicillin/clavulanic acid (p < 0.01), and azithromycin (p < 0.01).

Conclusions: Children aged 12–35 months received most of the antibiotic prescriptions, especially in rural areas. In urban areas, fewer and narrower-spectrum antibiotics are prescribed, with a lower use of amoxicillin/clavulanic acid and azithromycin.

What is Known?

• Antibiotics are the most commonly prescribed drugs in the pediatric population throughout Europe, with children aged 0-4 years, along with the population over 75 years of age, being the age groups where antibiotics are mostly used.

• Upper respiratory tract infections and acute otitis media are the most common diseases for which antibiotics are prescribed.

What is New?

• In recent years, antibiotic prescription rates in children have decreased and the quality of prescriptions has improved, with fewer prescriptions of amoxicillin/clavulanic acid and azithromycin and an increased use of penicillin and amoxicillin.

• Antibiotic prescription rates in children are higher in rural areas than in urban areas, with a greater tendency to use broad-spectrum antibiotics in the former.