No change in incidence between 1997 and 2004; increase seen in broad spectrum antibiotic use
WEDNESDAY, Feb. 16 (HealthDay News) -- Despite introduction of the heptavalent pneumococcal conjugate vaccine in 2000, incidence rates of community-acquired pneumonia (CAP) did not change between 1997 and 2004, according to a study published online Feb. 14 in Pediatrics.
Matthew P. Kronman, M.D., from The Children's Hospital of Philadelphia, and colleagues identified 1- to 18-year-old children with CAP based on the National Ambulatory and National Hospital Ambulatory Medical Care Surveys from 1994 to 2007. Rates of outpatient CAP were determined according to age group. Factors involved in broad-spectrum antibiotic prescribing from 2006 to 2007 were identified.
The investigators found that annual CAP outpatient visit rates were highest for children aged 1 to 5. There was no change in ambulatory CAP rates between 1994 and 2007. Macrolides were prescribed for 34 percent of patients, cephalosporins for 22 percent, and penicillins for 14 percent. There was a significant increase in cephalosporin use between 2000 and 2007. Prescribing of broad spectrum antibiotics was associated with being older, going to a non-emergency department office, and having a radiograph or complete blood count.
"The unchanged rate of outpatient pediatric CAP diagnosis, despite introduction of heptavalent pneumococcal conjugate vaccine, suggests that better diagnostics are needed to distinguish bacterial from viral pneumonia. Likewise, efforts to improve bacterial pneumonia diagnosis have the potential to decrease broad-spectrum antibiotic overuse significantly," the authors write.
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