Inappropriate antibiotic prescriptions are frequent among children with common infections treated in an outpatient setting, according to a study published in JAMA Network Open. Anne M. Butler, PhD, and colleagues conducted a cohort study of 2.8 million children aged 6 months to 17 years diagnosed with a bacterial or viral infection as an outpatient from April 1, 2016 to September 30, 2018, to examine the safety and healthcare expenditures of inappropriate versus appropriate oral antibiotic prescriptions. Among children, 31% to 36% and 4% to 70% received inappropriate antibiotics for bacterial infections and viral infections, respectively. Among children treated with a non-recommended antibiotic for a bacterial infection, inappropriate antibiotics were associated with an increased risk for several adverse drug events, including Clostridioides difficile and severe allergic reaction (HRs, 6.23 and 4.14, respectively, among patients with suppurative otitis media). Among children who received inappropriate antibiotics, 30-day attributable healthcare expenditures were generally higher.
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