Narrow- and Broad-Spectrum Antibiotic Use among U.S. Children

Health Serv Res. 2015 Jun;50(3):830-46. doi: 10.1111/1475-6773.12260. Epub 2014 Nov 25.


Objectives: To provide updated estimates of narrow- and broad-spectrum antibiotic use among U.S. children.

Data sources: Linked nationally representative data from the 2004-2010 Medical Expenditure Panel Survey Household Component and the 2000 Decennial Census.

Study design: Relationships between individual-, family-, and community-level characteristics and the use of antibiotics overall and in the treatment of respiratory tract infections (RTIs) are examined using multinomial choice models.

Principal findings: More than one quarter (27.3 percent) of children used at least one antibiotic each year with 12.8 percent using broad-spectrum and 18.5 percent using narrow-spectrum antibiotics. Among children with use, more than two-thirds (68.6 percent) used antibiotics to treat RTIs. Multivariate models revealed many differences across groups in antibiotic use, overall and in the treatment of RTIs. Differential use was associated with a broad range of factors related to need (e.g., age, health status), resources (e.g., insurance status, parental income, and education), race-ethnicity, and Census region.

Conclusions: Despite encouraging reports regarding the declining use of antibiotics, large differences in use associated with resources, race-ethnicity, and Census regions suggest a need for further improvement in the judicious and appropriate prescribing of antibiotics for U.S. children.

Keywords: Children; antibiotics; multinomial choice model; narrow- and broad-spectrum.

MeSH terms

  • Adolescent
  • Age Distribution
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / classification*
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Drug Utilization / statistics & numerical data*
  • Female
  • Humans
  • Infant
  • Male
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Respiratory Tract Infections / drug therapy*
  • Sex Distribution
  • Socioeconomic Factors
  • United States


  • Anti-Bacterial Agents