Eight-year trends in pediatric drug use examined

By Sarah Guy

A review of US outpatient pediatric drug use over the past 8 years shows a decrease in systemic antibiotic, allergy, pain, and depression prescriptions, and an increase in asthma, attention deficit/hyperactivity disorder (ADHD), and contraceptive prescriptions.

However, overall, the results show a statistically significant decrease in prescriptions dispensed to the pediatric population, say the study authors in Pediatrics.

"Identification of drugs with the highest numbers of patients exposed can help focus research efforts on those drugs that could have a large impact on the pediatric population," write Grace Chai (United States Public Health Service, Silver Spring, Maryland, USA) and co-workers.

Monitoring patterns of drug use also forms part of the risk/benefit evaluation of therapies for children, since clinicians often rely on data from adult clinical studies that lack specificity in pediatric populations, they add.

Using data from the IMS Vector One National database, the team calculated that 263 million prescriptions were dispensed to pediatric patients (aged 0‑17 years) in 2010, an overall decrease of 7% from 2002, and an average yearly decrease of 2.4 million since then.

While the researchers observed significant decreasing trends in allergy (-61%), cough/cold without expectorant (-42%), and systemic antibiotic (-14%) prescriptions, this last prescription type remained the most frequently dispensed ‑ accounting for 24‑27% of the total.

Several drugs showed a significant increase in use by the pediatric population between 2002 and 2010, including asthma (14%), dermal corticosteroids (10%), and oral corticosteroids (22%).

However, the largest increasing trend over the time period, at an additional 0.8 million prescriptions per year, was in the ADHD drug market, and the largest increase in prescriptions dispensed overall was for contraceptives, at 93% dispensed per million females aged 0‑17 years in 2012 compared with 88% in 2002.

However, Chai and team remark that 20-year data gathered by the Centers for Disease Control and Prevention do not show an increase in the overall percentage of young women taking contraception, thus the current results could reflect an increase in duration of use, or use for other indications such as acne.

The findings of the study can be used to help identify "off-label use" in pediatrics, highlighting areas for future research, conclude Chai et al.

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