Antibiotic Prescriptions for Kids Plummeted During the Pandemic

Prescription medications for children dropped overall during the first eight months of the pandemic, but antibiotic prescriptions, in particular, plummeted during this time, according to a new study.

The July study, which was published in the journal Pediatrics, analyzed national prescription drug dispensing data from 92% of pharmacies in the U.S. for children up to 19 years. They compared data from April to December in both 2020 and 2019. 

Between January 2018 and February 2020, a median of 25.7 million monthly prescriptions were given to children. In March 2020, that number fell to 25.68 million and, in April 2020, it was down to 16.7 million.

In December 2020 that dropped down to 15.8 million. Overall, 27.1% fewer prescription medications were dispensed from April to December 2020, compared to that same time frame in 2019. The drop was even more severe for antibiotic prescriptions: Those were nearly 56% lower than the previous year.

“This drop might be concerning if it represented delayed diagnosis of serious infections,” lead study author Kao-Ping Chua, MD, PhD, a pediatrician and researcher at the University of Michigan Health C.S. Mott Children's Hospital and the Susan B. Meister Child Health Evaluation and Research Center, tells Verywell. “However, if this occurred, one would expect increases in pediatric emergency department visits and hospitalizations for serious infections, and data show that the exact opposite has occurred.”

Antibiotic Prescriptions Dropped

Experts say there are likely a few factors driving this sudden drop.

“The more likely explanation is that there were fewer infections because of social distancing measures and mask use,” Chua says. “Because there were fewer infections, there were fewer visits and therefore fewer opportunities to receive antibiotic prescriptions.”

Danelle Fisher, MD, a pediatrician and chair of pediatrics at Providence Saint John’s Health Center in California, agrees. “Kids weren’t getting sick as much as usual because they were staying home,” she tells Verywell.

Chua says that there were also fewer opportunities for doctors to overprescribe antibiotics and, conversely, for parents to demand unnecessary antibiotic prescriptions. Chua points out that his previous research has also shown that there are plenty of antibiotics that are prescribed that are unnecessary.

“At least one in six antibiotics prescribed to children are for antibiotic-inappropriate conditions, such as colds,” he says. “Given that viral infections have decreased, some of the declines in antibiotic dispensing likely represents a drop in inappropriate antibiotic prescriptions.”

Doctors Are Not Shocked By the Findings

Fisher says that she’s “not at all” surprised by the findings, adding, “I prescribed less myself.”

Julie Ellis, MD, urgent care pediatrician at Mercy Medical Center in Maryland, tells Verywell that she also saw fewer infections like strep throat and pneumonia that would often be treated with antibiotics thanks to social distancing measures and mask usage.

“Therefore, there were fewer antibiotics prescribed,” she says. “It’s kind of exciting to know that very simple measures can help us decrease antibiotic use in children.”

The Data Should Be a Wakeup Call

Inappropriate antibiotic prescriptions are a real problem, Jamie Alan, PhD, PharmD, an associate professor of pharmacology and toxicology at Michigan State University, tells Verywell.

“Many childhood illnesses—sore throat, earache, etc.—can be caused by either bacteria or a virus,” she says. “Sometimes physicians prescribe antibiotics when they are not needed for many reasons: Sometimes it's out of an abundance of caution. Other times, it's to soothe the parent.”

But the problem with prescribing unnecessary antibiotics is that “bugs can develop antibiotic resistance,” Alan says, adding, “it’s really a fine line to walk.” If there are more bacteria that are resistant to antibiotics “we will run out of drugs to treat the infection,” Alan points out. 

At the same time, Chua says that the data show that it’s possible to prevent infections—and fewer antibiotic prescriptions will follow.

“Our study suggests that it is possible to greatly reduce antibiotic dispensing to children if we can prevent infections,” he says. “Even when the pandemic is over, families and schools should continue to emphasize basic infection control measures, such as hand hygiene.”