Study: Antibiotic Prescriptions for Children Drop Significantly Amid Pandemic

A new study published in Pediatrics showed a decrease in prescription drug dispensing for children during the COVID-19 pandemic, including for infection-related medicines and chronic disease treatments.

As a result of the COVID-19 pandemic, many children have made fewer visits to health facilities in the past year due to social distancing practices and other COVID-19 regulation rules. A recent study showed a decline in overall prescription drugs, particularly antibiotics and chronic disease medications, dispensed to children during the pandemic.

The study, which was published in Pediatrics, demonstrated that antibiotic prescriptions for children and teenagers plummeted in the United States during the pandemic. Antibiotic dispensing to children and teenagers fell by approximately 56% between the months of April and December 2020 compared with the same period in 2019. There was also a decline in prescriptions for chronic diseases, such as attention deficit hyperactivity disorder (ADHD) and asthma. However, there was no change in prescriptions for antidepressants.

Medications prescribed for kids lessened by over a quarter during the first 8 months of the pandemic. This was a comparison with the previous year, with the greatest decline seen in infection-related medicines such as antibiotics and cough-and-cold drugs. Chronic disease drug dispensing rates did not decline as rapidly as antibiotic dispensing rates, the results showed. Overall, drugs typically prescribed for acute infections, including antibiotics, fell by nearly 51%, whereas those for chronic diseases fell by 17%.1 This may be a positive development from the pandemic due to the adverse effects (AEs) of some antibiotics and antibiotic resistance; however, the decreased adherence and dispensing of chronic disease treatments may be a cause for concern.

National prescription drug dispensing data were used from 92% of US pharmacies during the COVID-19 pandemic. Dispensing totals were 27.1% lower from April to December 2020 compared with the same period in 2019. Of the 3 drug classes accounting for the most prescriptions in 2019, the percent changes were 55.6% for antibiotics, 11.8% for ADHD medications, and 0.1% for antidepressants.

“The decrease in antibiotic dispensing most likely reflects reductions in infections, such as colds and strep throat, due to COVID-19 risk–mitigation measures like social distancing and face masks,” said lead author Kao-Ping Chua, MD, PhD, a pediatrician and researcher at the University of Michigan Health C.S. Mott Children’s Hospital and the Susan B. Meister Child Health Evaluation and Research Center. “As a result, children had fewer infection-related visits and had fewer opportunities to receive antibiotic prescriptions, whether for antibiotic-appropriate conditions or antibiotic-inappropriate conditions.”

“Whether this decline is concerning needs to be studied further,” Chua added. “For example, it is unclear whether the decline in ADHD prescriptions reflects a reduced need for medications at school due to the transition to remote learning, disruptions in medication access or delays in diagnosis.”

The decrease in dispensing of chronic disease drugs is a cause for concern and should be monitored and investigated further, the authors concluded. It will also be important to assess whether the decline in infection-related drugs is temporary or sustained.1

References

1. Prescription drug dispensing to US children during the COVID-19 pandemic. Chua K-P. Volerman A, Conti RM. Pediatrics July 2021, e2021049972; DOI: https://doi.org/10.1542/peds.2021-049972

2. Ross J. Antibiotic prescriptions for kids plummet during pandemic. University of Michigan Medicine; July 20, 2021. Accessed July 26, 2021. https://labblog.uofmhealth.org/rounds/antibiotic-prescriptions-for-kids-plummet-during-pandemic