title: Trends in antimicrobial prescribing rates for Alaska Native and American Indian persons <18 years of age residing in the Anchorage region.
abstract: OBJECTIVE
  In the U.S., the total number of antimicrobials prescribed in ambulatory care declined between 1989 and 2000; however, antimicrobial resistance increased among many pathogens. We evaluated antimicrobial prescribing patterns from 1992 to 2004 in Alaska Native/American Indian (AI/AN) persons
  
  
  METHODS
  Retrospective study based on medical records.
  
  
  METHODS
  Medical records were used to obtain data on oral antibiotics prescribed for ambulatory and emergency-room visits. Antimicrobial prescribing rates were calculated per population and per ambulatory-clinic visit.
  
  
  RESULTS
  The total number of antimicrobial courses prescribed increased 94% from 4,929 (1992) to 9,561 (2004). However, the total number of ambulatory-clinic visits also increased (79%) from 49,008 (1992) to 87,486 (2004), while the population of AI/AN persons <18 in Anchorage region rose 14%. The population-based rate of antimicrobial prescriptions (per 1,000 persons) rose from 309 (1992) to 524 (2004 (p<0.001). The visit-based annual rate (per 1,000 visits) remained stable from 101 (1992) to 109 (2004) (=0.651). Overall, visit-based prescriptions rates in AI/AN persons were lower than previously reported among children in the U.S. (range 250-340). Penicillins comprised >50% of antimicrobials presribed from 1992 to 2004. Visit-based prescribing rates from 1992 to 2004 changed: penicillin, +27% (p=0.210): cephalosporins, +33% (p=0.23); trimethoprim-sulfamethexazole, -48% (p<0.001).
  
  
  CONCLUSIONS
  Visit -based antimicrobial prescribing rates in the Anchorage region for AI/AN children receiving care in the AI/AN health system have been stable over a 13-year period. Although a trend in decreased antibiotic prescribing has been seen in the general U.S. population, visit-based prescribing rates in the Anchorage region for AI/AN children have remained below those in previous studies in the U.S.
authors.affiliation: Alaska Native Medical Center, Anchorage, USA.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Bott
authors.forename: Michael G
authors.initials: MG
authors.lastname: Bruce
authors.forename: Lisa
authors.initials: L
authors.lastname: Bulkow
authors.forename: John
authors.initials: J
authors.lastname: Coleman
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Hennessy
mesh_terms: D000413:Alaska; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American; D007223:Infant; D007231:Infant, Newborn; D004930:Inuit; D008485:Medical Audit; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012189:Retrospective Studies; D014505:Urban Population
chemical_list: D000900:Anti-Bacterial Agents