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.