Antibiotic usage, dosage and course length in children between 0 and 4 years

Aim: Antibiotic drugs are most frequently used by 0‐ to 4‐year‐old children. We performed a cross‐sectional study in the Netherlands using a pharmacy prescription database to investigate the use, dose and course length of antibiotic drugs in 0‐ to 4‐year‐olds. Methods: We used a database with pharmacy drug‐dispensing data. We investigated all prescriptions of systemic antibiotics prescribed in the years 2002–2006 for children of 0–4 years of age. Prescriptions for children under the age of 3 months were excluded. Results: Children of 9–12 months of age received more antibiotics than children in other age groups. In the 3‐ to 6‐month‐olds, amoxicillin was prescribed in 75.2% of the cases. This percentage was 50.4% in the 4‐year‐olds. The contribution of other broad‐spectrum antibiotics increased with age (clarithromycin and amoxicillin/clavulanic acid). Small‐spectrum penicillins were prescribed less often than the broad‐spectrum antibiotics. From the prescriptions of the five most used drugs, 97.6% were within the recommended dose range. Most course lengths corresponded with the guidelines. Of the prescriptions, 3.9% were unlicensed or off‐label. Conclusion: Within the group of 0‐ to 4‐year‐old children, most antibiotics were used by 9‐ to 12‐month‐olds. The doses and course lengths were mostly correct, but the choice of antibiotics was not according to the guidelines. Young children received unlicensed and off‐label prescribed antibiotics.