our results for birth season cohort effects corresponded with patterns of acute otitis media, a prominent indication for antibiotic treatment, which peaks in winter and for children >6 months old.12 Researchers for two previous studies18,19 have considered seasonal differences in antibiotic prescribing in children, also showing peak prescribing in winter. However, because those studies focused on rates, interpreting seasonality was tied to time periods of peak usage rather than to intrinsically different cohorts of children (ie, birth season cohorts). Other prominent studies of antibiotic prescribing in children1,9,17,20,39 have not included explicit assessments of seasonal differences.
These new findings on birth season cohort effects inform future researchers focused on antibiotics as the exposure in 2 ways: (1) antibiotic exposure status might differ meaningfully between children born in different seasons, and (2) birth season differences in age at first antibiotic use might modify intended or unintended effects of antibiotic treatment given some children’s increased vulnerability to microbial insults in early life.42,43
This is the first study in which the impact of the IRF bulletin (in 2007) and PCV programs (from 2007 onward) on pediatric antibiotic prescribing patterns in Denmark is explicitly evaluated. Ecologic data on PCV receipt among children in Denmark have revealed evidence of sharp increases in coverage from ∼50% (children born in 2006) to sustained levels >85% for children born from 2007 to 2012.44–46 PCV programs have been associated with marked decreases in invasive pneumococcal disease in Danish children.47 Our results therefore provide potential evidence of a downstream effect of vaccination on antibiotic dispensing brought about by decreases in the proportion of children presenting with bacterial infections requiring antibiotic treatment.
No comments:
Post a Comment