Antibiotic use in the pediatric population: factors to consider

The aim of this retrospective study was to analyze the use of antibiotics in pediatrics in the Canary Islands during the period 2001-2005. We used the defined daily dose (DDD) as a technical unit of measurement as well as the DDD/1000 habitants/day (DHD), following the ATC classification system. The demographic data were obtained from individual patient health cards assigned to the primary care pediatricians. During the period 2001-2005, the total number of prescriptions for antibiotics in pediatrics was 1,207,726 at a cost of 6,119,679 Euros to the Canarian Health Service in Tenerife and 4,808,654 Euros in Las Palmas. The annual number of DHD in the Canary Islands decreased from 103,044 in 2001 to 68,168 in 2005. The cost for 1000 inhabitants/day (CHD) was 27,686 Euros and 19,183 Euros in Tenerife and Las Palmas, respectively. In analyzing the therapeutic classes of antibiotics, we found that the consumption of broad-spectrum penicillins (amoxicillin) in Tenerife decreased, while in Las Palmas it remained stable. There was also a significant decrease in the use of tetracyclines in both provinces. The DHD of beta-lactamase inhibitors was more significantly reduced in Tenerife than in LPA. The consumption of cephalosporins, mainly cefixime, was high in Tenerife, while in Las Palmas the second-generation cephalosporins (cefuroxime and cefaclor) were widely consumed. The use of macrolide antibiotics gradually decreased. Interestingly, there were 7,939 prescriptions for fluoroquinolones (mainly ciprofloxacin) in Tenerife and 4,846 in Las Palmas (mainly norfloxacin and ciprofloxacin). There were differences in the prescribing practices between Tenerife and Gran Canaria that don't coincide with changes in the microbiological spectrum. Prescribing practices in Las Palmas are based on scientific data, probably because of the continuing education courses on antibiotherapy that began in 2003.