Trends in Community Antibiotic Dispensing for Children and Young People in Aotearoa New Zealand, 2010–2019: Implications for Antimicrobial Stewardship

Aim To analyse trends in community systemic antibiotic dispensing to children and young people (0–14 years) in New Zealand between 2010 and 2019. Methods Dispensing data were retrieved from the National Pharmaceuticals Collection and population data from the Te Whatu Ora Populations Web Tool. Dispensing rates were described using the number of defined daily doses/1000 inhabitants per day (DID) and courses dispensed/1000 inhabitants/year. Results Total antibiotic dispensing declined over the study period, both in terms of courses dispensed (annual percentage change [APC] −3.4% per year) and DIDs (APC −0.67% per year). Amoxicillin/clavulanic acid showed the greatest decline in dispensing (APC −9.5% per year), while cefalexin had the most significant increase (APC +53.7% per year). The highest dispensing rates were observed among children aged 0–4 years, Pacific patients and those in the lowest socioeconomic quintile. Counties Manukau had the highest regional dispensing rates. Antibiotic stewardship, as per the WHO AWaRe guidelines, improved: Access antibiotics increased from 83% to 91%, while Watch antibiotics decreased from 17% to 9% of total dispensing. Conclusions These findings suggest an overall improvement in prescribing practices, likely due to the adoption of antimicrobial stewardship programmes. Further study is under way to understand the reasons for and any risks associated with, high community rates of cefalexin dispensing.