Background: Antibiotic overuse is a major public health problem. Despite global recognition of potential adverse results associated with overuse of antibiotics, limited pediatric data suggest that marked variability in the use of these medications across countries persist. We aimed to describe the rates of pediatric antibiotic use across three continents.
Methods: Cross-national analysis of 7 pediatric cohorts in 6 countries (Germany, Italy, Korea, Norway, Spain and the US) was performed for the years 2008-2012. Antibiotic Dispensings were identified and grouped into subclasses. We calculated the rates of antimicrobial prescriptions per person-year specific to each age group, comparing the rates across different countries.
Results: A total of 74,744,302 person-years from all participating centers were included in the analysis. Infants in South Korea had the highest rate of antimicrobial consumption, with 3.41 prescribed courses per child-year during the first two years of life. This compares with 1.6 in Lazio, Italy, 1.4 in Pedianet, Italy, 1.5 in Spain, 1.1 in the U.S., 1.0 in Germany, and 0.5 courses per child-year in Norway. 64.8% of antimicrobial prescriptions in Norway were for first-line penicillins, compared to 38.2% in Germany, 31.8% in the US, 27.7% in Spain, 25.1% in the Italian Pedianet population but only 9.8% of prescriptions in South Korea and 8% in the Italian Lazio population.
Conclusions: We found substantial differences of up to 7.5-fold in pediatric antimicrobial use across several industrialized countries from Europe, Asia and North America. These data reinforce the need to develop strategies to decrease the unnecessary use of antimicrobials.
