# Antibiotic prescriptions to preschool children with respiratory tract infections in primary healthcare

## TL;DR

This study examines how often antibiotics are prescribed to young children in Norway for respiratory infections and finds a gradual decrease in prescriptions over time.

## Contribution

The study provides a detailed analysis of antibiotic prescription trends and patterns in preschool children with respiratory infections in Norway from 2012 to 2019.

## Key findings

- Antibiotic prescription rates for preschool children decreased from 28% in 2012 to 19% in 2019.
- Penicillins were the most commonly prescribed antibiotics, increasing from 50% to 68% of prescriptions over the study period.
- The reduction in antibiotic prescriptions was linked to a decline in RTI episode rates, particularly for otitis.

## Abstract

Correct use of antibiotics ensures necessary treatment for patients while antibiotic resistance is reduced. Respiratory tract infections (RTIs) are common in preschool children. Young children receive a large proportion of the total amount of antibiotics, and also in low-prescribing countries such as Norway.

Explore the contacts, rate of antibiotic prescriptions and choice of antibiotics in the treatment of RTIs in preschool children in general practice from 2012 to 2019. Methods Descriptive registry study on complete population data of antibiotic prescriptions administered to Norwegian pre-school children with RTIs, in the period 2012 – 2019, after consultations with a general practitioner

The total prescription rate was reduced from 28% in 2012 to 19% in 2019. There were small yearly variations in prescription rates. Most antibiotics were prescribed to 1- and 2-year-olds. Upper RTI was the most used diagnosis and accounted for 25% of the total amount of antibiotics prescribed.

Total RTI episode rate was 941 episodes/1000 children in 2012, reduced by 17% to 2019 when there were 777 episodes/1000 children. The reduction in antibiotic prescription to children with otitis was associated with a decline in episode rate.

More than 81% of prescribed antibiotics were penicillins, only 16% were macrolides and 3% were other antibiotics. The use of phenoxymethylpenicillin increased in the period from 50% in 2012 to 68% in 2019.

There is room for improvement in adherence to guidelines and antibiotic stewardship also in low-prescribing countries. Antibiotic prescribing is closely linked to prescription rates and health-seeking behaviours, offering valuable insights for targeted antibiotic stewardship campaigns.