Antibiotic use for airway infections in Norwegian children-A national register-based study

Aim: Respiratory tract infections (RTIs) are major contributors to childhood antibiotic use. We aimed to investigate geographical and temporal trends in the prescription of antibiotics and consultations for RTIs in children <18 years living in Norway from 2010 to 2017.Methods: In a nationwide observational study, we analysed antibiotic prescriptions from the Norwegian Prescription Database and reimbursed contacts from primary care physicians. We limited the study to airway antibiotics and diagnostic codes indicating RTIs.Results: Antibiotic prescriptions due to an RTI varied from 75 to 134 per 1000 consultation due to RTI across counties in Norway (relative risk 1.79, 95% CI 1.68-1.90 for highest compared to lowest). The use of health care varied from 414 to 585 consultations for RTI per 1000 inhabitant/year (relative risk 1.43, 95% CI 1.41-1.44 for highest compared to lowest). From 2010 to 2017, we observed a 21% reduction in antibiotic prescriptions per RTI consultation and of 6% for the number of consultations for an RTI. At the county level, the use of health care was positively associated with the proportion of RTIs that resulted in antibiotic prescription.Conclusion: We found a reduction in doctors' antibiotic prescription and the use of health care for RTIs, and a variation across counties.