Background: Updated data on pediatric drug utilization patterns are critical in informing whether pediatric drug use is rational and for identifying potential areas of suboptimal use.
Objectives: To characterize the pattern of non-antibiotic drug prescribing in Danish children and adolescents in terms of prevalence, quantity, and temporal changes.
Methods: Using Danish nationwide individual-level prescription data, we identified all redeemed prescriptions issued for children and adolescents (age < 18 years) from 1 January 2005 to 31 December 2021. For all drugs, we computed overall annual prevalence proportions of users and mean number of prescriptions per child per year. For all non-antibiotic drugs, we further determined the quantity of drug use measured in defined daily doses (DDDs), and stratified all analyses by age and according to first and fourth levels of the anatomical therapeutic chemical classification system. Lorenz curves were computed to illustrate potential skewness of drug consumption.
Results: During the study period, there was a decreasing trend in the mean number of yearly prescriptions per child from 1.9 in 2005 to 1.7 prescriptions per child in 2021. Similarly, the annual prevalence of children receiving at least one prescription decreased from 57% in 2005 to 48% in 2021. Disregarding antibiotic prescriptions, the prevalence proportion of children receiving at least one prescription was stable throughout the observation period (39% in 2021), while the mean number of prescriptions and DDDs increased from 1.2 prescriptions and 42.3 DDDs per child in 2005 to 1.4 prescriptions and 61.2 DDDs in 2021. The prevalence of non-antibiotic drug use was highest among adolescents 12-17 years of age (46% in 2021), and the most commonly used medication classes were selective beta-2-receptor agonists (5.5%), benzimidazole derivatives (4.6%), inhaled and topical group II corticosteroids (4.0 and 4.6%), and combined progesterons and estrogens for contraceptive use (3.4%). We found substantial skewness in children’s prescription drug use with 10% of children accounting for almost 50% of all non-antibiotic drug use in 2021.
Conclusions: The quantity of non-antibiotic prescription drug use is increasing in Danish children and adolescents. Further analyses are needed to determine what drives this development and to determine areas where current prescription practice may not be rational.
