Utilization of nonguideline concordant antibiotic treatment following acute otitis media in children in the United States

Purpose Acute otitis media (AOM) is a common indication for antibiotics in children. We sought to characterize the frequency of nonguideline concordant antibiotic therapy for AOM in the United States, by agent and duration. Methods Using national administrative claims data (2016–2019), we identified...

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Bibliographic Details
Published in:Pharmacoepidemiology and drug safety 2023-02, Vol.32 (2), p.256-265
Main Authors: McGrath, Leah J., Frost, Holly M., Newland, Jason G., O'Neil, Caroline A., Sahrmann, John M., Ma, Yinjiao, Butler, Anne M.
Format: Article
Language:English
Subjects:
Acute Disease
administrative data
Age
Amoxicillin
Amoxicillin-Potassium Clavulanate Combination
Anti-Bacterial Agents - therapeutic use
antibacterial agents
Antibiotics
Azithromycin
Cefdinir
Child
Children
data visualization
Diagnosis
drug utilization
Ear diseases
guideline adherence
Humans
Infant
Medicaid
Otitis Media
pediatrics
United States
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Summary:Purpose Acute otitis media (AOM) is a common indication for antibiotics in children. We sought to characterize the frequency of nonguideline concordant antibiotic therapy for AOM in the United States, by agent and duration. Methods Using national administrative claims data (2016–2019), we identified children aged 6 months to 17 years with an oral antibiotic dispensed within 3 days of a new diagnosis of suppurative AOM. Use of nonguideline concordant agents and durations, defined based on national treatment guidelines, were summarized by age, race, rurality, region, and insurance type. Subsequent oral antibiotic dispensing within the year after AOM diagnosis was also evaluated. We created sunburst diagrams to visualize longitudinal patterns of within‐person antibiotic utilization for AOM, by agent and duration. Results We identified 789 424 eligible commercially‐insured and 502 239 medicaid‐insured children. Among commercially insured children, 35% received nonguideline concordant agents for AOM, including cefdinir (16%), amoxicillin‐clavulanate (12%), and azithromycin (7%). Fewer children age 
ISSN:1053-8569
1099-1557
DOI:10.1002/pds.5554