• Nhung T H Trinh, Tim A Bruckner, Magali Lemaitre, Françoise Chauvin, Corinne Levy, Pierre Chahwakilian, Robert Cohen, Martin Chalumeau, and Jérémie F Cohen.
• Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Centre for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France; IQVIA, La Défense, France. Electronic address: nhung.trinh@inserm.fr.
• J. Pediatr. 2020 Jan 1; 216: 88-94.e4.

ObjectiveTo test whether updated clinical practice guidelines for managing upper respiratory tract infections released in France in November 2011 were associated with changes in national outpatient pediatric antibiotic use.Study DesignWe performed an interrupted time-series analysis using national antibiotic dispensation data in French children from January 2009 to December 2017 (IQVIA Suivi de la Dispensation Médicale database). We described the overall evolution of antibiotic prescription rates and modeled the changes in the proportion of amoxicillin and the proportion of broad-spectrum antibiotics following the guidelines in 2 age groups (0-5 and 6-14 years old).ResultsWe analyzed 123 million pediatric antibiotic prescriptions. The most commonly prescribed individual antibiotic agent was amoxicillin (37.7%). Over the study period, the annual antibiotic prescription rate decreased by 33.1% (from 1387 to 928 per 1000 pediatric inhabitants per year), consistently across age groups and major antibiotic agents except for amoxicillin (+14.4%). After the release of the guidelines, we observed a gradual increase in the proportion of amoxicillin (relative change 5 years postintervention of +64.3% [95% CI 51.6-80.1] and +28.4% [21.1-36.2] for children 0-5 and 6-14 years, respectively) concomitantly with a gradual decrease in the proportion of broad-spectrum antibiotics (relative change 5 years postintervention of -26.1% [-29.3, -23.7] and -19.8% [-22.1, -16.0] for children 0-5 and 6-14 years old, respectively).ConclusionsThe 2011 guidelines for upper respiratory tract infections preceded changes in outpatient pediatric antibiotic use at the national level, with a replacement of broad-spectrum antibiotics by amoxicillin.Copyright © 2019 Elsevier Inc. All rights reserved.

25 keywords...

hide…