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| |  CPS: Use of Antibiotics Decreasing, but Some Areas See an Increase By Pippa Wysong Special to DG News TORONTO, ON -- June 14, 2002 -- Although physicians are encouraged to prescribe fewer antibiotics in an effort to decrease antibiotic resistance, a study from Winnipeg shows that prescribing patterns vary according to which neighborhood pediatric patients live in. Despite an overall decrease in the percentage of children given an antibiotic prescription, a study of the trends in antibiotic prescribing patterns from 1995 to 2000 in Winnipeg, Manitoba, Canada, revealed that a decreasing number of antibiotics were prescribed to children living in higher-income areas, while those in lower-income areas were prescribed more. Anita Kozyrskyj, PhD, of the Manitoba Centre for Health Policy, Winnipeg, presented details of the study at the 79th Annual Meeting of the Canadian Paediatric Society. Researchers used the Manitoba Health Services Insurance Plan database, which contains province-wide prescription data, and socio-economic information was attained from Statistics Canada. Neighborhoods were categorized into income quintiles using household income data from the 1996 Statistics Canada census, and comparisons were made between the lowest and highest quintiles. "For the study, children were defined as being less than 19 years old at December 31 of each study year," she said. The study included data on about 350,000 children. For the 1995-1996 year, the data revealed that 50 percent of all children had received at least one prescription for an antibiotic. This number dropped to 42 percent in 1999-2000. The number of children who were given five or more prescriptions dropped during the same time period from 5 percent to 3 percent. However, the youngest children, aged one to four years, got the highest number of antibiotics in both time periods. Most of the children who were given prescriptions were given extended spectrum antibiotics. "The use of both narrow and extended spectrum antibiotic prescriptions decreased from 1995 to 2000, but not to the same extent for all types of antibiotics," Dr. Kozyrskyj said. During this time, doctors were less likely to prescribe narrow-spectrum antibiotics, with a drop from 20 percent to 14 percent. The use of penicillins and erythromycins dropped from 10 percent to 6 percent. Certain other categories of antibiotics dropped too, with the use of extended spectrum antibiotics dropping from 40 percent to 35 percent. Use of extended spectrum penicillins dropped slightly from 33 percent to 28 percent. But not all antibiotic usage dropped. The use of extended spectrum macrolides increased from 1 percent to 4 percent during the study period, she said. In urban areas, children living in poorer neighborhoods were 1.2 times more likely than their wealthier counterparts to receive at least one prescription for an antibiotic. Lower-income neighborhoods "may become pockets of antibiotic resistance", and this is something to study, Dr. Kozyrskyj said. Children in higher-income neighborhoods were also less likely to be prescribed extended spectrum penicillins. The use of extended spectrum macrolides saw an increase in both income groups. The study opens the door to researching physicians’ prescribing habits to understand this difference in prescribing patterns, she said.
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