Patterns of Antibiotic Dispensing Among New Zealand Children: A Linkage Study
Sharan Ram, Marine Corbin, Amanda Kvalsvig, Michael G. Baker, Andrea ‘t Mannetje, Amanda Eng, Jeroen DouwesABSTRACT
Background
Overuse of antibiotics contributes to antibiotic resistance, and may result in gut microbiome dysbiosis, potentially increasing the risk of chronic childhood conditions.
Objectives
To examine patterns of antibiotic dispensing in utero and during the first 5 years of life.
Methods
We conducted a retrospective cohort study of all children ( n = 315 786) born in New Zealand from 2005 to 2010 using linked pharmaceutical dispensing data to ascertain antibiotic use during the mother's pregnancy and for the first 5 years of life. Descriptive analyses were conducted as well as negative binomial regression controlled for potential confounders.
Results
In total, 96% of children had been dispensed ≥ 1 course of antibiotics by age five; for pregnant women this was 30%. Penicillin, particularly Amoxicillin, was most frequently dispensed during both periods. Postnatal antibiotic dispensing was higher for males (adjusted IRR 1.09, 95% CI 1.08–1.10); Māori (1.16, 1.15–1.17), Pacific peoples (1.32, 1.30–1.33), and Middle East Latin American and African (MELAA) ethnicities (1.07, 1.04–1.10); children in the highest deprivation quintile (1.16, 1.15–1.17) and those born pre‐term (1.05, 1.04–1.05); and urban children (1.21, 1.20–1.22). Low and high birthweight and caesarean deliveries were also associated with higher antibiotic dispensing. Similar patterns were observed for antibiotic dispensing for mothers during pregnancy. Dispensing rates were highest during winter months.
Conclusion
Antibiotic dispensing is high in New Zealand children and pregnant women, with significant ethnic and socioeconomic differences, suggesting that current antibiotic stewardship programmes are not fully effective.