Analysis finds global antibiotic use varies widely in children

A new global study indicates that among children younger than age 5 years, narrow-spectrum antibiotics comprised more than three-quarters of antibiotics used by young children for common childhood bacterial infections in 70 countries.

A new global study indicates that among children younger than age 5 years, narrow-spectrum antibiotics comprised more than three-quarters of antibiotics used by young children for common childhood bacterial infections in 70 countries. However, in 17 countries, most notably China and India, broader-spectrum drugs represented more than 20% of the antibiotics used by children, according to the study in The Lancet Infectious Diseases. Narrow-spectrum antibiotics are preferred over broader spectrum ones as the first or second options for treatment. The study—conducted by researchers from St. George's University of London, the University of Hong Kong, and the World Health Organization—was based on sales volume in 2015 of childhood appropriate formulations (CAFs) obtained from a global pharmacy retail sales database. The study also found that the median amoxicillin index—the percentage of amoxicillin sold in each country—was 30.7%, with the drug accounting for more than 50% of CAFs in 15 countries and less than 10% in 11 countries. Because amoxicillin is one of the most effective and safe antibiotics, "for children, countries should strongly promote the use of amoxicillin for most common antibiotic treatment indications encountered in community practice," the authors write. Another key finding was the range of CAFs that were unclassified—from 0.8% in Russia to 33.6% in Germany. The researchers suggested that using metrics to assess antibiotic use in young children would help countries monitor inappropriate use and develop antibiotic stewardship targets.