The number of prescriptions written for teens, children and infants fell 7% between 2002 to 2010, countering the trend in adults, among whom prescriptions rose 22% over the same time period, according to a new study by the Food and Drug Administration (FDA) published in the journal Pediatrics.
While overall pediatric prescriptions declined, the use of certain drugs increased: asthma medications, attention-deficit hyperactivity disorder (ADHD) drugs and birth control pills.
FDA researchers used two commercial prescription and patient databases that held data on prescriptions filled by outpatient retail pharmacies, accounting for about half of all retail prescriptions in the U.S. They looked at prescriptions written for kids up to age 17 between 2002 and 2010.
In 2010, a total of 263.6 million prescriptions were given to U.S. kids in the U.S., a 7% reduction since 2002. Among the drugs that declined in use: antibiotic prescriptions, which fell by 14%, though antibiotics were still the most frequently dispensed medications for kids; allergy meds, which dropped by 61%; cough and cold drugs, down by 42%; pain meds, down by 14%; and depression medications, which fell by 5%.
The authors credit the decrease in antibiotics prescriptions to widespread initiatives by public-health experts to encourage doctors and parents to stop overusing the drugs — especially for viral infections that can’t be cured with antibiotics — and to educate the public on the increase in antibiotic resistance caused by overprescribing. “Our analyses suggest such efforts may be working,” the authors write.
The authors also cite a 2008 FDA health advisory discouraging the use of over-the-counter cold and cough meds for infants under age 2 as a positive influence on the prescription numbers.
At the same time, the researchers saw significant spikes in prescriptions for ADHD, asthma and birth control medications. They report a 46% increase in prescriptions for ADHD meds, including drugs like Ritalin and Adderall, which they suggest indicates increases in ADHD diagnoses. The number of U.S. children between ages 3 to 17 diagnosed with ADHD jumped from 4.4 million in 2002 to 5 million in 2010, the authors say.
“I think the large rise in numbers [of prescriptions] reflects not just the increase in the number of children and adolescents with the condition, but also the availability of markedly improved medicines. We now have once-a-day long-acting meds to treat ADHD,” Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven and Alexandra Children’s Medical Center of New York, told CNN.
Other observers noted that the use of ADHD drugs in the U.S. far outstrips rates in other countries. “You have to look at how our society handles school children’s problems. It’s clear that we rely much, much more on a pharmacological answer than other societies do,” Dr. Lawrence Diller, a behavioral pediatrician who has written extensively about ADHD, told Reuters. “The medicine is overprescribed primarily, but underprescribed for certain inner-city groups of children.”
Contraceptive prescriptions rose 93%, but the researchers note that national surveys have not found much of an increase among girls taking birth control pills in the last 20 years. The rise could reflect an increase in the duration of use or an increase in use for other reasons like acne treatment.
“This type of data is important to identify gaps in research. We have shared this data in the hopes that others will initiate research to better understand how medications are used in children,” Sandy Walsh, a spokesperson for the FDA, told CNN.