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. 2022 Jul;31(7):749-757.
doi: 10.1002/pds.5438. Epub 2022 Apr 19.

Antibiotic use in children before, during and after hospitalisation

Christian Magnus Thaulow  1   2 , Hege Salvesen Blix  3   4 , Roy Miodini Nilsen  5 , Beate Horsberg Eriksen  6   7 , Jannicke Slettli Wathne  8 , Dag Berild  9 , Stig Harthug  1   10
Affiliations

Antibiotic use in children before, during and after hospitalisation

Christian Magnus Thaulow et al. Pharmacoepidemiol Drug Saf. 2022 Jul.

Abstract

Purpose: To investigate ambulatory antibiotic use in children during 1 year before and 1 year after in-hospital antibiotic exposure compared to children from the general population that had not received antibiotics in-hospital.

Methods: Explorative data-linkage cohort study from Norway of children aged 3 months to 17 years. One group had received antibiotics in-Hospital (H+), and one group had not received antibiotics in-hospital (H-). The H+ group was recruited during admission in 2017. Using the Norwegian Population Registry, 10 children from the H- group were matched with one child from the H+ group according to county of residence, age and sex. We used the Norwegian Prescription Database to register antibiotic use 1 year before and 1 year after the month of hospitalisation.

Results: Of 187 children in the H+ group, 83 (44%) received antibiotics before hospitalisation compared to 288/1870 (15%) in the H- group, relative risk (RR) 2.88 (95% confidence interval 2.38-3.49). After hospitalisation, 86 (46%) received antibiotics in the H+ group compared to 311 (17%) in the H- group, RR 2.77 (2.30-3.33). Comorbidity-adjusted RR was 2.30 (1.84-2.86) before and 2.25 (1.81-2.79) after hospitalisation. RR after hospitalisation was 2.55 (1.99-3.26) in children 3 months-2 years, 4.03 (2.84-5.71) in children 3-12 years and 2.07 (1.33-3.20) in children 13-17 years.

Conclusions: Children exposed to antibiotics in-hospital had two to three times higher risk of receiving antibiotics in ambulatory care both before and after hospitalisation. The link between in-hospital and ambulatory antibiotic exposure should be emphasised in future antibiotic stewardship programs.

Keywords: ambulatory antibiotic use; antibiotic use; antimicrobial resistance; epidemiology; hospital antibiotic use; paediatric antibiotic use.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Relative comorbidity adjusted risk for different antibiotic exposures in children 1 year before and 1 year after admission to hospital for antibiotic treatment. The reference was a group from the general population that had not received antibiotics in‐hospital. Oral broad‐spectrum antibiotics are defined as co‐trimoxazole, clindamycin, cephalexin and ciprofloxacin. The marked vertical lines indicate the 95% CI [Colour figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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