Socioeconomic status and the likelihood of antibiotic treatment for signs and symptoms of pulmonary exacerbation in children with cystic fibrosis

J Pediatr. 2011 Nov;159(5):819-824.e1. doi: 10.1016/j.jpeds.2011.05.005. Epub 2011 Jun 25.

Abstract

Objective: To determine whether socioeconomic status (SES) influences the likelihood of antibiotic treatment of pulmonary exacerbations in patients with cystic fibrosis (CF).

Study design: 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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use*
  • Canada / epidemiology
  • Child
  • Child, Preschool
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / epidemiology
  • Drug Utilization / statistics & numerical data*
  • Female
  • Humans
  • Infusions, Intravenous
  • Longitudinal Studies
  • Male
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / epidemiology
  • Social Class*
  • United States / epidemiology

Substances

  • Anti-Bacterial Agents