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Recurrent Antibiotic Use in Kentucky Children With 6 Years of Continuous Medicaid Enrollment.
Journal of the Pediatric Infectious Diseases Society ( IF 2.5 ) Pub Date : 2022-12-05 , DOI: 10.1093/jpids/piac079
Bethany A Wattles 1 , Michael J Smith 2 , Yana Feygin 3 , Kahir S Jawad 3 , Sagnik Bhadury 4 , Jingchao Sun 4 , Maiying Kong 4 , Charles R Woods 5
Affiliation  

BACKGROUND Little is known about the distribution of antibiotic use in individual children over time. The amoxicillin index is a recently proposed metric to assess first-line antibiotic prescribing to children. METHODS We constructed a cohort of continuously enrolled Medicaid children using enrollment claims from 2012 to 2017. Pharmacy claims were used to identify antibiotic prescription data. RESULTS Among 169 724 children with 6 years of Medicaid enrollment, 10 804 (6.4%) had no antibiotic prescription claims during the study period; 43 473 (25.6%) had 1-3 antibiotics; 34 318 (20.2%) had 4-6 antibiotics; 30 994 (18.3%) had 7-10; 35 018 (20.6%) had 11-20; and 15 117 (8.9%) children had more than 20 antibiotic prescriptions. Overall, the population had a median total of 6 antibiotic prescriptions during the study period, but use was higher in certain patient groups: younger age (8 antibiotic fills over the 6-year period, [IQR 4-14]), White children (7 [IQR 3-13], compared to 3 [IQR 1-6] in Black children), rural settings (9 [IQR 4-15]) and chronic conditions (8 [IQR 4-15]). Higher-use groups also had lower rates of amoxicillin fills, reported as amoxicillin indices. CONCLUSIONS Antibiotic use is common among most children insured by Kentucky Medicaid. A number of fills over time were higher in younger children, and in White children, children living in rural settings and children with chronic conditions. Patients with higher recurrent antibiotic use are important targets for designing high-impact antibiotic stewardship efforts.

中文翻译:

连续 6 年参加医疗补助计划的肯塔基州儿童反复使用抗生素。

背景 关于随着时间的推移,个别儿童的抗生素使用分布知之甚少。阿莫西林指数是最近提出的评估儿童一线抗生素处方的指标。方法 我们使用 2012 年至 2017 年的入学声明构建了一组连续注册的医疗补助儿童。药房声明用于识别抗生素处方数据。结果 在参加 Medicaid 6 年的 169 724 名儿童中,10 804 名 (6.4%) 在研究期间没有抗生素处方索赔;43 473 (25.6%) 人使用过 1-3 种抗生素;34 318 (20.2%) 人有 4-6 种抗生素;30 994 (18.3%) 有 7-10;35 018 (20.6%) 有 11-20;15 117 名 (8.9%) 儿童的抗生素处方超过 20 种。总的来说,在研究期间,人群平均有 6 种抗生素处方,但某些患者群体的使用率更高:年龄较小(6 年期间 8 次抗生素填充,[IQR 4-14]),白人儿童(7 [IQR 3-13],相比之下 3 [IQR 1-6]在黑人儿童中)、农村环境(9 [IQR 4-15])和慢性病(8 [IQR 4-15])。较高使用组的阿莫西林填充率也较低,报告为阿莫西林指数。结论 肯塔基州医疗补助计划投保的大多数儿童普遍使用抗生素。随着时间的推移,年幼儿童、白人儿童、农村儿童和患有慢性病的儿童的填充次数更高。抗生素使用率较高的患者是设计高效抗生素管理工作的重要目标。与黑人儿童中的 3 [IQR 1-6] 相比)、农村环境(9 [IQR 4-15])和慢性病(8 [IQR 4-15])。较高使用组的阿莫西林填充率也较低,报告为阿莫西林指数。结论 肯塔基州医疗补助计划投保的大多数儿童普遍使用抗生素。随着时间的推移,年幼儿童、白人儿童、农村儿童和患有慢性病的儿童的填充次数更高。抗生素使用率较高的患者是设计高效抗生素管理工作的重要目标。与黑人儿童中的 3 [IQR 1-6] 相比)、农村环境(9 [IQR 4-15])和慢性病(8 [IQR 4-15])。较高使用组的阿莫西林填充率也较低,报告为阿莫西林指数。结论 肯塔基州医疗补助计划投保的大多数儿童普遍使用抗生素。随着时间的推移,年幼儿童、白人儿童、农村儿童和患有慢性病的儿童的填充次数更高。抗生素使用率较高的患者是设计高效抗生素管理工作的重要目标。随着时间的推移,年幼儿童、白人儿童、农村儿童和患有慢性病的儿童的填充次数更高。抗生素使用率较高的患者是设计高效抗生素管理工作的重要目标。随着时间的推移,年幼儿童、白人儿童、农村儿童和患有慢性病的儿童的填充次数更高。抗生素使用率较高的患者是设计高效抗生素管理工作的重要目标。
更新日期:2022-08-14
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