Overuse of Antibiotics in Children Runs Up Staggering Health Care Costs: Study

Overuse and inappropriate use of antibiotics among children increases the risk they will suffer serious side effects, while also increasing patient costs and overall healthcare costs, according to the findings of a new study.

In a report published last week in the medical journal JAMA Network Open, researchers from Washington University School of Medicine warn that children prescribed antibiotics inappropriately often suffer side effects, such as severe allergic reactions or Clostridium difficile (C. diff) infections. The over-use of the drugs also places a cost burden on patients and the healthcare system overall.

Antibiotic overuse has been a topic of concern in recent years, as more data indicates that the practice is contributing to the proliferation of antibiotic-resistant bacteria, which lead to more than 35,000 deaths every year in the U.S. alone. Unnecessary use of antibiotics has also contributed to an increase in C. diff infections, which are notoriously difficult to treat and lead to more than 150,000 deaths every year.

In this latest study, researchers evaluated data on more than 2.8 million children ages 6 months to 17 years old with commercial insurance, who were diagnosed with bacterial infection or viral infection as an outpatient from April 2016 to September 2018. Data was taken from the IBM MarketScan Commercial Database.

The study found that one-third of pediatric patients received inappropriate antibiotic prescriptions for bacterial infections, such as suppurative otitis media, pharyngitis, and sinusitis.

Anywhere from 4% up to 70% of patients received inappropriate prescriptions for antibiotics for viral infections like the flu, viral upper respiratory infections, bronchitis, and non-suppurative otitis media.

Inappropriate antibiotics also increased the risk of generally higher 30-day all-cause attributable expenditures. Increased expenditures ranged from $21 to $56 per patient for bacterial infections and $96 to $97 for viral infections.

The national annual expenditures for inappropriate antibiotic use among pediatric patients were the highest for suppurative otitis media at $25.3 million, pharyngitis at $21.3 million, and viral upper respiratory infection at $19.1 million.

Inappropriate antibiotic prescribing is when a patient is given antibiotics for ailments that cannot be successfully treated with antibiotics, such as viral infections, or giving them the wrong type of antibiotic for a specific condition that should be treated with a different class of antibiotics. Previous studies have indicated antibiotic overuse is linked to doctor prescribing habits, often in urgent care and outpatient clinics.

Additionally, inappropriate antibiotics are associated with increased risk of severe adverse drug events including Clostridium difficile infection and severe allergic reaction among children treated with non-recommended antibiotics for bacterial infections.

Antibiotic overuse in children has been linked to developing debilitating bowel disorders later in life, including conditions like inflammatory bowel disease and colitis.

“These findings highlight the individual- and national-level consequences of inappropriate antibiotic prescribing and further support implementation of outpatient antibiotic stewardship programs,” the researchers concluded.