Node Smith, ND
A recent study on antibiotic prescribing patterns has estimated that approximately a third of all antibiotics prescribed for children, globally, are meant to prevent potential infection rather than treat a current infection or disease.1 The published findings were part of a worldwide survey and can be found in the Journal of the Pediatric Infectious Diseases Society.
Using broad spectrum antibiotics for any and all prophylactic purposes is contrary to current guidelines for antibiotic use
A large percentage of the prophylactic, or preventative, prescriptions were broad-spectrum antibiotics, which has the increased potential of furthering the development of antibiotic resistant bacteria. The use of broad spectrum antibiotics for prophylactic purposes as well as using any antibiotic for prophylactic purposes, in many instances, is contrary to current guidelines for antibiotic use.
32.9 percent of children were prescribed an antibiotic to prevent a potential infection rather than treat a current one
The study gives a snapshot of a single day of antibiotic prescriptions in 226 hospitals in 41 countries, including 4 in the United States. There were a total of 11,899 prescriptions written for 6,818 children for antibiotics. Of children who were prescribed 1 antibiotic or more, 32.9 percent of children were prescribed an antibiotic to prevent a potential infection rather than treat a current one.
73.4 percent of prophylactic prescriptions were used to prevent potential infections
26.6 percent of these prophylactic antibiotics were associated with an upcoming surgery, and the majority were taken for more than a single day. The other 73.4 percent of prophylactic prescriptions were used to prevent potential infections. Over half of these prescriptions were for broad-spectrum antibiotics, and in 36.7 percent of cases, more than one systemic antibiotics were used simultaneously.
These patterns contradict current guideline recommendations for prophylactic antibiotic use
These suggested patterns do contradict current guideline recommendations for prophylactic antibiotic use. Most guidelines call for the use of narrow-spectrum antibiotics for short periods, for the intended purpose of limiting the chance of developing antibiotic resistance. For this same reason, guidelines advocate reduction of antibiotic use before surgery, as well as for prevention of infection rather than therapeutic use, expect in certain instances.
- Markus Hufnagel et al. High Rates of Prescribing Antimicrobials for Prophylaxis in Children and Neonates: Results From the Antibiotic Resistance and Prescribing in European Children Point Prevalence Survey. Journal of the Pediatric Infectious Diseases Society, 2018.
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Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.