Pediatric Acute Sinusitis Visit Rates Unchanged

Visits stable after vaccine introduction, but amoxicillin use increased in line with guidelines

THURSDAY, Dec. 30 (HealthDay News) -- Office and emergency department visits for acute sinusitis among children appear to have remained stable since the introduction of the heptavalent pneumococcal conjugate vaccine, but amoxicillin use has increased substantially in accordance with American Academy of Pediatrics guidelines, according to a study published online Dec. 27 in Pediatrics.

Using data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (1998 to 2007), Daniel J. Shapiro, of the University of California in San Francisco, and colleagues evaluated time trends in visit rates and antibiotic prescribing among 538 children younger than 18 years of age with diagnosed acute sinusitis.

From 1998 to 2007, the investigators found that the annual visit rate for acute sinusitis remained stable, ranging from 11 to 14 visits per 1,000 children (P = .67). In addition, no significant change occurred in the proportion of visits with receipt of an antibiotic (82 percent). However, between 1998 and 2007, the proportion with receipt of amoxicillin increased from 19 to 58 percent. The investigators also found that it was relatively common (18 percent overall) for practitioners to prescribe broader-spectrum agents, especially macrolides.

"Although prescriptions for amoxicillin increased in accordance with the guidelines, reducing unnecessary prescriptions for macrolides remains an important target for campaigns promoting judicious antibiotic use," the authors write.

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