Patterns of Antibiotic Prescribing for Pediatric Outpatient Visits in the United States: Findings From the National Ambulatory Medical Care Survey 2010-2015

Sep 28, 2026

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Inappropriate antibiotic prescribing for children remains a major public health threat, fueling antimicrobial resistance, adverse events, and avoidable healthcare costs. This cross-sectional analysis evaluates antibiotic prescribing patterns in U.S. pediatric outpatient visits from 2010 to 2015 using the National Ambulatory Medical Care Survey (NAMCS). Antibiotic use was assessed by diagnosis category, age group, and patient characteristics with descriptive statistics and adjusted probabilities.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Methods

Results

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Review began 11/16/2025 Review ended 11/23/2025 Published 12/01/2025 © Copyright 2025 Okobi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98245 Open Access Original Article Patterns of Antibiotic Prescribing for Pediatric Outpatient Visits in the United States: Findings From the National Ambulatory Medical Care Survey 2010-2015 Okelue E. Okobi 1, 2 , Emmanuel Olawusi 3, Wuraola R. Awosan 4, Chibuzo N. Nwodo 5, Ifesinachi Nwankwor 6 , Angelina Uzor 7 1. Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA 2. Family Medicine, IMG Research Academy and Consulting LLC, Homestead, USA 3. Pediatrics, Maimonides Medical Center, New York City, USA 4. Medicine, Ternopil National Medical University, Ternopil, UKR 5. Ear, Nose, and Throat (ENT), Royal Derby Hospital, Derby, GBR 6. General Practice, General Hospital Agulu, Agulu, NGA 7. Public Health, East Tennessee State University, Johnson City, USA Corresponding author: Emmanuel Olawusi, [emmanuelolawusi@gmail.com](emmanuelolawusi@gmail.com) Abstract Background: Inappropriate antibiotic prescribing for children remains a major public health concern, contributing to antimicrobial resistance (AMR), adverse events, and excess healthcare costs. This study examined prescribing patterns in United States (US) pediatric outpatient visits between 2010 and 2015 using the National Ambulatory Medical Care Survey (NAMCS) . Methods: We conducted a cross-sectional analysis of outpatient encounters for patients aged 0-17 years. Antibiotic prescribing was evaluated by diagnosis category, age group, and patient characteristics. Descriptive statistics and adjusted probabilities were generated. Missing data were assessed, with no imputation applied, as most key variables were complete. Results: Among 45,666 unweighted pediatric visits, representing 991,561,251 weighted visits, the strongest predictor of antibiotic use was the type of diagnosis. Bacterial infections, particularly otitis media and urinary tract infections, had the highest prescribing probabilities, while non-infectious diagnoses rarely received antibiotics. Respiratory illnesses accounted for substantial prescribing, consistent with prior reports of inappropriate use. Conclusion: Pediatric antibiotic prescribing during 2010-2015 was primarily diagnosis-driven, with persistent overuse for respiratory conditions. These results underscore the need for strengthened outpatient stewardship strategies to reduce inappropriate use and support guideline-concordant care. Categories: Family/General Practice, Internal Medicine, Pediatrics Keywords: antibiotic stewardship, antimicrobial resistance, namcs, outpatient care, pediatrics, prescribing patterns Introduction In the United States (US) and the world, prescribing antibiotics to pediatric patients continues to be a serious public health concern [1] . Although antibiotics are vital for treating various bacterial infections, their inappropriate or unnecessary use significantly contributes to the emergence of antimicrobial resistance (AMR), adverse drug events, and rising health expenditures, according to the Centers for Disease Control and Prevention (CDC) [2,3] . The World Health Organization (WHO) defines AMR as one of the greatest health risks all over the globe, and children are especially vulnerable because they have a lot of contact with healthcare specialists and their immune system is not fully developed [4] . In the US, outpatient settings, especially primary care and urgent care clinics, account for a majority of antibiotic prescriptions, making them a focal point for antibiotic stewardship efforts [5] . Prescribing patterns also differ based on age group, category of the diagnosis, and geography [6] . Y

FAQs

What problem does the study address?

The study addresses inappropriate antibiotic prescribing for children and its links to antimicrobial resistance, adverse events, and excess healthcare costs.

How were antibiotic prescribing patterns evaluated?

Antibiotic use was assessed using NAMCS data for pediatric outpatient encounters aged 0–17 by diagnosis category, age group, and patient characteristics, with descriptive statistics and adjusted probabilities.

What were the main findings about when antibiotics were used?

Antibiotic use was driven primarily by diagnosis type; bacterial infections such as otitis media and urinary tract infections showed the highest prescribing probabilities, while non-infectious diagnoses rarely received antibiotics. Respiratory conditions accounted for substantial prescribing, indicating persistent overuse.

Sep 28, 2026

Uploaded by Kurz