Assessing and comparing antibiotic therapy trends for children with acute otitis media from 2005 to 2014 in U.S
Open Access
- Author:
- Hashem, Nehal Gamal
- Graduate Program:
- Public Health Sciences
- Degree:
- Master of Science
- Document Type:
- Master Thesis
- Date of Defense:
- July 07, 2017
- Committee Members:
- Douglas L Leslie, Thesis Advisor/Co-Advisor
Du, Ping, Committee Member
Kristen H Kjerulff, Committee Member - Keywords:
- Acute otitis media
children
antibiotics - Abstract:
- Background Approximately 30% of antibiotics prescribed in the outpatient setting is unnecessary. The centers for Disease Control and Prevention (CDC) has identified a number of infectious diseases states that have been associated with inappropriate use of antibiotics, including acute otitis media (AOM). The objective of this study is to assess the variation in the rate of antibiotic prescribing for children with acute otitis media over time across the U.S. Methods We analyzed data from the Truven Health MarketScan Research database. The database includes primarily commercial health insurance data submitted from 2005 through 2011. The study sample included all children under the age of 12 years old with an ICD-9 diagnosis for acute otitis media (382, 384.20, 384.29). The primary outcome is filling a prescription for an antibiotic medication. Rates of antibiotic prescribing were compared over time and across U.S. Census regions. Logistic regression was used to identify demographic (age and sex) and geographic (U.S. Census regions) factors associated with antibiotic use for AOM. Results A total of 6,764,655 children aged less than 12 years old with a diagnosis of acute otitis media were identified after eliminating children with any missing values. Overall, the mean age was 4.33.2 years. The distribution of the sample by U.S. Census region was as follows: 15.6% (n=1,059,978) in the North region, 23.3% (n=1,577,475) in the Midwest region, 43.8% (n=2,959,741) in the South region and 17.3% (n=1,167,461) in the West region. Overall, 60.7% of AOM children received an antibiotic, with rates of antibiotic use being highest in the West (62.7%), followed by the Midwest (61.8%), the South (60.5%), and the North (57.4%). Conclusion Based on the results of this study, overall antibiotic usage for acute otitis media for children with under age of 12 appears to be stable over the past decade, although rates vary dramatically by U.S. Census region. This shows the inconsistence of practice among different regions and need for standardization for treatment of AOM.