Objective: Most primary care clinical guidelines recommend restrictive antibiotic use for childhood infections. We investigated antibiotic prescription rates over time for oral and topical antibiotics for children (≤12 years) in the period 2000-2010.
Design, setting and patients: Longitudinal observational study among children (≤12 years) in a large Dutch general practice database in the period 2000-2010.
Main outcome measures: Oral and topical antibiotic prescribing rates per year and independent factors influencing antibiotic prescriptions.
Results: We analysed 108 555 patient-years during 2000-2010. At least one chronic disease was recorded in 15.8% of patient-years, with asthma most commonly registered. In 14.8% of the patient-years at least one antibiotic was prescribed, while 26.3% of these received two or more prescriptions. Young age and chronic disease had a significant effect on antibiotic prescriptions. Prescriptions for oral and topical antibiotics increased 4.9% and 1.8%, respectively, during 2000-2005 (p<0.001). Prescription rates for oral antibiotics decreased 3.3% during 2006-2010 (p<0.001), while topical prescribing rates remained stable.
Conclusions: One in six children received at least one oral antibiotic prescription per year during 2000-2010. While topical prescription rates steadily increased during 2005-2010 and remained stable during 2006-2010, prescription rates for oral antibiotics increased significantly during the period 2000-2005 and then significantly decreased during the period 2006-2010. As clinical guidelines remained the same over this period, the effects could be contributed to the initiation of the Dutch nationwide pneumococcal vaccination campaign in 2006.