title: Exposure to antibiotics in a United States-Mexico border birth cohort.
abstract: OBJECTIVE
  The goal was to compare the frequency of children's antibiotic intake, emphasizing antibiotics with anti-Helicobacter pylori effects, in El Paso, Texas, and Juarez, Mexico.
  
  
  METHODS
  Hispanic children were enrolled prenatally at mother-child clinics in El Paso, and Juarez, in 1998-2000, to identify determinants of H pylori infection. During follow-up examinations targeted every 6 months from 6 to 84 months of age, caretakers reported medication use during the preceding interval. Courses of any systemic and H pylori-effective antibiotics were compared for US and Mexican children.
  
  
  RESULTS
  Antibiotic data were available for 602 children, from 2938 follow-up visits. Overall antibiotic intake was higher in Juarez, where 84% of children received > or = 1 course during the follow-up period (52% of visits), compared with El Paso, where 76% of children received > or = 1 course (40% of visits). In contrast, the intake of H pylori-effective antibiotics was higher in El Paso, where 65% of children received > or = 1 course during the follow-up period (27% of visits), compared with Juarez, where 44% of children received > or = 1 course (16% of visits). Of H pylori-effective courses, 94% contained amoxicillin and 2% each clarithromycin, metronidazole, and furazolidone; uses were primarily for throat and ear infections, diarrhea, and cold/flu.
  
  
  CONCLUSIONS
  Pediatric antibiotic use was higher in Mexico than on the US side of the border. Apparent misuse of H pylori-effective antibiotics was more frequent in Juarez but also occurred in El Paso. Such misuse of antibiotics may lead to drug resistance and may impair the control of H pylori infection in this region.
authors.affiliation: School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA. gnp2@cdc.gov
authors.forename: Cheryl S
authors.initials: CS
authors.lastname: Broussard
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Goodman
authors.forename: Zhannat Z
authors.initials: ZZ
authors.lastname: Nurgalieva
authors.forename: Lori A
authors.initials: LA
authors.lastname: Fischbach
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Gold
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D007223:Infant; D008297:Male; D008800:Mexico; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013781:Texas
chemical_list: D000900:Anti-Bacterial Agents