Association of Inappropriate Outpatient Pediatric Antibiotic Prescriptions With Adverse Drug Events and Health Care Expenditures

Do adverse events and health care expenditures differ in children given inappropriate vs appropriate oral antibiotic prescriptions for common outpatient infections?

 In this cohort study of more than 2.8 million children with commercial insurance, inappropriate antibiotics were associated with increased risk of several adverse drug events (eg, Clostridioides difficile infection, severe allergic reaction) and generally higher 30-day all-cause attributable expenditures. National annual expenditure estimates associated with inappropriate antibiotic treatment in the pediatric commercially insured population were highest for suppurative otitis media, pharyngitis, and viral upper respiratory infection.

In this cohort study of children with common infections treated in an outpatient setting, inappropriate antibiotic prescriptions were common and associated with increased risks of adverse drug events and higher attributable health care expenditures. These findings highlight the individual- and national-level consequences of inappropriate antibiotic prescribing and further support implementation of outpatient antibiotic stewardship programs.