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June 19, 2002

Dynamics of Antibiotic Prescribing for Children

Author Affiliations

Author Affiliation: University of Rochester Medical Center, Rochester, NY.

JAMA. 2002;287(23):3133-3135. doi:10.1001/jama.287.23.3133

The dynamics that influence antibiotic prescribing by office-based physicians in the United States are complex. Physicians have been receiving repeated messages to curtail antibiotic use from the biomedical literature, medical and public media, health insurance companies, key opinion leaders, alternative medicine advocates, and some patients. The message has been consistent, frequent, and loud, so it cannot have been missed. The crescendo of research during the past decade has established that (1) antibiotic overuse is a major public health problem1; (2) approximately 50% of prescriptions for children written by community-based practitioners are unnecessary,2 and (3) the single most important factor in the emergence of antibiotic resistance among respiratory bacterial pathogens is selection pressure from antimicrobial agents.3 Thus, as a public health policy, there seems little doubt that overzealous prescribing habits and inappropriate use of antibiotics should be reduced on a community-wide basis.