title: Individual maternal and child exposure to antibiotics in hospital - a national population-based validation study.
abstract: OBJECTIVE
  Exposure to antibiotics in early life may affect future health. Most antibiotics are prescribed in outpatient care, but inpatient exposure is also important. We estimated how specific diagnoses in hospitals corresponded to individual antibiotic exposure.
  
  
  METHODS
  All pregnant women and children from birth to 5 years of age with infectious diseases and common inpatient diagnoses between July 2005 and November 2011 were identified from the Swedish National Patient Register. Random samples of individuals from predefined groups were drawn, and medical records received from the clinics were manually reviewed for antibiotics.
  
  
  RESULTS
  Medical records for 4319 hospital visits were requested and 3797 (88%) were received. A quarter (25%) of children diagnosed as premature had received antibiotics, and in children from one to 5 years of age, diagnoses associated with bacterial infections were more commonly treated with antibiotics (62.4-90.6%) than those associated with viruses (6.3-22.2%). Pregnant women who had undergone a Caesarean section were more likely to be treated with antibiotics than those who had had a vaginal delivery (40.1% versus 11.1%).
  
  
  CONCLUSIONS
  This study defines the proportion of new mothers and young children who received individual antibiotic treatment for specific inpatient diagnoses in Sweden and provides a useful basis for future studies focusing on antibiotic use.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Lung and Allergy Unit, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Almqvist
authors.forename: A K
authors.initials: AK
authors.lastname: Örtqvist
authors.forename: T
authors.initials: T
authors.lastname: Gong
authors.forename: A
authors.initials: A
authors.lastname: Wallas
authors.forename: K M
authors.initials: KM
authors.lastname: Ahlén
authors.forename: W
authors.initials: W
authors.lastname: Ye
authors.forename: C
authors.initials: C
authors.lastname: Lundholm
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002675:Child, Preschool; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D013548:Sweden
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Bacterial infections; Pregnancy; Prematurity; Viruses