title: Socioeconomic status and the likelihood of antibiotic treatment for signs and symptoms of pulmonary exacerbation in children with cystic fibrosis.
abstract: OBJECTIVE
  To determine whether socioeconomic status (SES) influences the likelihood of antibiotic treatment of pulmonary exacerbations in patients with cystic fibrosis (CF).
  
  
  METHODS
  We used data on 9895 patients ≤ 18 years old from the Epidemiologic Study of CF. After establishing an individual baseline of clinical signs and symptoms, we ascertained whether antibiotics were prescribed when new signs/symptoms suggested a pulmonary exacerbation, adjusting for sex, presence of Pseudomonas aeruginosa, the number of new signs/symptoms, and baseline disease severity.
  
  
  RESULTS
  In a 12-month period, 20.0% of patients <6 years of age, 33.8% of patients 6 to 12 years of age, and 41.4% of patients 13 to 18 years of age were treated with any (oral, intravenous (IV), or inhaled) antibiotics; the percentage receiving IV antibiotics was 7.3%, 15.2%, and 20.9%, respectively. SES had little effect on treatment for pulmonary exacerbation with any antibiotics, but IV antibiotics were prescribed more frequently for patients with lower SES.
  
  
  CONCLUSIONS
  SES-related disparities in CF health outcomes do not appear to be explained by differential treatment of pulmonary exacerbations.
authors.affiliation: Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA. Michael.Schechter@emory.edu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Schechter
authors.forename: Susanna A
authors.initials: SA
authors.lastname: McColley
authors.forename: Warren
authors.initials: W
authors.lastname: Regelmann
authors.forename: Stefanie J
authors.initials: SJ
authors.lastname: Millar
authors.forename: David J
authors.initials: DJ
authors.lastname: Pasta
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Wagener
authors.forename: Michael W
authors.initials: MW
authors.lastname: Konstan
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Morgan
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000453:epidemiology; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008137:Longitudinal Studies; D008297:Male; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000453:epidemiology; D012923:Social Class; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents