BACKGROUND Antibiotic prescription for uncomplicated upper respiratory tract infection (URTI) in children is not recommended but remains common. The primary objective was to evaluate the relationship between antibiotic prescription for URTI prior to age 2 and antibiotic prescription for URTI after age 2. It was hypothesized that antibiotic prescription for URTI in early childhood may increase the risk of antibiotic use for subsequent URTIs. The secondary objective was to investigate whether this relationship was different for acute otitis media (AOM), for which antibiotics may be indicated. METHODS A prospective cohort study was conducted between December 2008 and March 2016 at 9 primary care practices in Toronto, Canada. Healthy children aged 0-5 years that met TARGet Kids! cohort eligibility criteria were included if they had at least one sick visit prior to age 2 and least one sick visit after age 2. Generalized Estimating Equation (GEE) models were used to evaluate this relationship while considering within-subject correlation. RESULTS Of 2380 participants followed for a mean duration of 4.6 years, children who received an antibiotic prescription for URTI prior to age 2 had higher odds of receiving an antibiotic prescription for URTI in later childhood (adjusted odds ratio: 1.39; 95% confidence interval: 1.19 to 1.63; P < .001). This relationship did not appear to be different for AOM compared to non-AOM URTI. CONCLUSION Antibiotic prescription for URTI before age 2 was associated with antibiotic prescription for URTI in later childhood. Reducing early life antibiotic prescription for URTI may be associated with reduction in antibiotic prescription for subsequent URTIs.

中文翻译：

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生命早期治疗上呼吸道感染的抗生素处方与儿童期抗生素使用量的增加有关。


背景技术 不推荐对儿童无并发症的上呼吸道感染（URTI）使用抗生素处方，但仍然很常见。主要目的是评估 2 岁之前的 URTI 抗生素处方与 2 岁之后的 URTI 抗生素处方之间的关系。假设儿童早期的 URTI 抗生素处方可能会增加后续 URTI 抗生素使用的风险。次要目标是调查这种关系对于急性中耳炎 (AOM) 是否有所不同，因为急性中耳炎可能需要使用抗生素。方法 2008 年 12 月至 2016 年 3 月期间，在加拿大多伦多的 9 个初级保健机构进行了一项前瞻性队列研究。遇见TARGet Kids的0-5岁健康儿童！如果他们在 2 岁之前至少有过一次病假，并且在 2 岁之后至少有过一次病假，则纳入队列资格标准。使用广义估计方程 (GEE) 模型来评估这种关系，同时考虑受试者内的相关性。结果 在 2380 名参与者中，平均随访时间为 4.6 年，在 2 岁之前接受 URTI 抗生素处方的儿童在儿童后期接受 URTI 抗生素处方的几率更高（调整后的比值比：1.39；95% 置信区间： 1.19 至 1.63；P< .001)。与非 AOM URTI 相比，AOM 的这种关系似乎没有什么不同。结论 2 岁前 URTI 抗生素处方与儿童后期 URTI 抗生素处方相关。减少生命早期治疗 URTI 的抗生素处方可能与减少后续 URTI 的抗生素处方有关。