US Pharm. 2021;46(8):1.

As children made fewer visits to health facilities and engaged in social distancing and other COVID-19 mitigation measures, a smaller number of them also received prescription drugs, a new study suggests. Overall, medications prescribed for children dropped by more than a quarter during the first 8 months of the pandemic compared with the previous year, with the steepest declines in infection-related medicines like antibiotics and cough-and-cold drugs.

Antibiotic dispensing to children and teens plunged by nearly 56% between April and December 2020 compared with the same period in 2019. Researchers also found declines in prescriptions for chronic diseases, such as attention-deficit/hyperactivity disorder and asthma, but no change in prescriptions for antidepressants, according to the findings in Pediatrics.

“The decline in the number of children receiving antibiotics is consistent with the large decreases in infection-related pediatric visits during 2020,” said lead author Kao-Ping Chua, MD, PhD, pediatrician and researcher at University of Michigan Health C.S. Mott Children’s Hospital and the Susan B. Meister Child Health Evaluation and Research Center.

“Because antibiotics have important side effects, the dramatic decreases in antibiotic dispensing may be a welcome development,” he added. “However, declines in dispensing of chronic disease drugs could be concerning.”

Researchers analyzed national prescription drug dispensing data from 92% of U.S. pharmacies to assess changes in dispensing to children ages birth to 19 years during COVID-19. Between January 2018 and February 2020, nearly 25.8 million prescriptions were dispensed to children per month. Dispensing totals during the first 8 months of the pandemic dropped by about 27% compared with the same period in 2019.

Overall, drugs typically prescribed for acute infections, including antibiotics, fell by nearly 51%, while those for chronic diseases fell by 17%. “The decrease in antibiotic dispensing most likely reflects reductions in infections, such as colds and strep throat, due to COVID-19 risk-mitigation measures like social distancing and face masks,” Dr. Chua said.

“As a result, children had fewer infection-related visits and had fewer opportunities to receive antibiotic prescriptions, whether for antibiotic-appropriate conditions or antibiotic-inappropriate conditions.”

Dr. Chua’s previous research has suggested that nearly a quarter of antibiotic prescriptions among children and adults may be unnecessary. In children, antibiotics are the leading cause of emergency room visits for adverse drug events, with potential side effects including allergic reactions, fungal infections, and diarrhea.

Long term, antibiotic overuse may also contribute to antibiotic-resistant bacteria development, causing illnesses that were once easily treatable with antibiotics to become untreatable and dangerous, he explained.

“This study provides a national picture of prescription drug dispensing to children before and during the pandemic,” Dr. Chua said.