ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2024
Variations in antibiotic prescribing among children enrolled in North Carolina Medicaid, 2013-2019.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- The changing landscape of outpatient antibiotic prescriptions among advanced practice clinicians in the United States, 2011 and 2022.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Article
- Analysis of antibiotic prescription in upper respiratory tract infections in children 0-4 years of age in primary care. Impact of age and health care setting.European journal of pediatrics · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
purposeThe majority of pediatric antibiotic prescribing occurs in the outpatient setting and inappropriate use contributes to antimicrobial resistance. There are regional variations in outpatient antibiotic use with the highest rates occurring in the Southern states, including in Appalachia. The purpose of this study was to describe the rates and risk factors for inappropriate antibiotic prescription among pediatric patients enrolled in North Carolina (NC) Medicaid.
methodsWe used Medicaid prescription claims data from 2013 to 2019 to describe patterns of pediatric antibiotic prescription in NC. We assessed patient and provider factors to identify variations in prescribing.
findingsChildren who were less than 2 years of age, non-Hispanic White, and living in a rural area had the highest overall rates of antibiotic prescription. Compared to pediatricians, the risk of inappropriate antibiotic prescription was highest among other specialists and general practioners and lowest among nurse practitioners. Rural areas of NC had the highest rates of inappropriate antibiotic prescribing, and the risk for non-Hispanic Black children compared to children of other races/ethnicities was compounded by rurality.
conclusionsPrescribing practices in NC differ compared to neighboring states with a lower overall risk of inappropriate prescription in Appalachian regions; however, disparities by race and rurality exist. Outpatient stewardship efforts in NC should focus on ensuring health equity by appreciating racial and geographic variations in prescribing patterns and providing education to all health care providers.
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