Hyattsville, MD—With some notable exceptions for specific medication classes and age groups, use of prescription drugs generally dropped for children and adolescents in the United States from 1999 to 2014.

That’s according to an article in the Journal of the American Medical Association. CDC-led researchers determined that the reported use of any prescription medication by children and adolescents in the past 30 days declined from 24.6% in 1999 to 2002 to 21.9% in 2011-2014.

The decreases weren’t across the board, however. The prevalence of asthma medication, ADHD medication, and contraceptive use increased among certain age groups, even while use of antibiotics, antihistamines, and upper respiratory combination medications dropped, according to the research by the CDC’s National Center for Health Statistics.

To develop the statistics, a study team reviewed information on 38,277 children and adolescents (from birth to age 19 years) who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. NHANES is a nationally representative survey conducted every 2 years.

The study determined that, in 2011-2014, the most commonly used medication classes were:
•  Asthma medications (6.1% [95% CI, 5.4% to 6.8%]) 
•  Antibiotics (4.5% [95% CI, 3.7% to 5.5%]) 
•  Attention-deficit/hyperactivity disorder (ADHD) medications (3.5% [95% CI, 2.9% to 4.2%])
•  Topical agents (e.g., dermatologic agents, nasal steroids) (3.5% [95% CI, 3.0% to 4.1%]), and 
•  Antihistamines (2.0% [95% CI, 1.7% to 2.5%]). 

“There were significant linear trends in 14 of 39 therapeutic classes or subclasses, or in individual medications, with eight showing increases, including asthma and ADHD medications and contraceptives, and six showing decreases, including antibiotics, antihistamines, and upper respiratory combination medications,” researchers wrote. 

Interestingly, trends in prevalence of ADHD medication use from 1999-2002 to 2011-2014 in children aged 6 to 11 years and in adolescents aged 12 to 19 years varied, the report notes. While use of those drugs increased among children aged 6 to 11 years—specifically amphetamines among adolescents—there were no statistically significant linear trends in overall use of ADHD medications or central nervous system stimulants. 

Prescriptions of centrally acting antiadrenergic agents, i.e., clonidine and guanfacine, commonly used to treat ADHD, increased, however. The study points out that new ADHD medications, including lisdexamfetamine and the selective norepinephrine reuptake inhibitor atomoxetine, were introduced during the study period, while guanfacine and clonidine were first approved to treat ADHD in 2009 and 2010.

Another notable statistic was that antibiotic use in children and adolescents plummeted by almost half between 1999 and 2002 and 2011 and 2014, especially involving amoxicillin-containing antibiotics and cephalosporins. Decreases were significant in all age groups except children aged 2 to 5 years, while children aged 0 to 23 months were the only age group to show decreasing medication use over time, with antibiotics being a large proportion of medications used in infants, the authors write.

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