Latest in health: Pediatric antibiotic usage decreases, autism diagnoses increase

Jun 24, 2018

Today in our latest in health segment: two recent Centers for Disease Control and Prevention (CDC) studies that reflect different trends in pediatric health.

First, a national survey showed a decrease in antibiotic usage among children and adolescents along with an increase in ADHD medication usage. Second, recent data from a New Jersey study suggests a nearly 20 percent increase in autism diagnoses in children.

"Seeing this trend decreasing over time is likely reflective of this increased awareness of this antibiotic resistance and potential over-prescription of antibiotics."

Fewer antibiotics, more ADHD medication

Increased awareness about safe antibiotic usage may be a factor in the decreasing trend of adolescent antibiotic medication reported by a recent CDC study, according to study’s the lead author.

Dr. Craig Hales, a preventive medicine physician at the CDC’s National Center for Health Statistics, said his study found that from 1999 to 2014, the percentage of children and adolescents who used prescription medication in the last 30 days decreased from 25 percent to 22 percent. The use of asthma and ADHD medications were shown to be the most prevalent.

Hales said the results may first appear to be disconcerting, but they are actually likely a positive reflection on the effectiveness of antibiotic safety awareness programs like the CDC program, Be Antibiotics Aware, Smart Use, Best Care.

“Seeing this trend decreasing over time is likely reflective of this increased awareness of this antibiotic resistance and potential over-prescription of antibiotics,” Hales said.

The strength of this study comes from its overall applicability to the entire nation, as it is a nationally recognized representative survey that assesses the health and nutritional status of all adults and children in the U.S. Hales said that while there have been other studies measuring similar data, those have been using large databases that can limit the results into a misleading conclusion.

Hale said his study’s face-to-face interviews give a much better picture of what is going on with medication usage, leading him to a strong confidence in its results.

Among the largest differences in groups of children were those with and without insurance, according to Hales. Twenty-three percent of kids with insurance took a prescription medication in the last 30 days, compared to 10 percent of uninsured kids.

Hales was surprised by the demographic results of the study as well, showing a relative increase among non-Hispanic, African American children. Because of these results, he felt such factors warranted further analysis.

“We could delve into that further and look at the patterns of use of different therapeutic classes of medication by race and ethnic group to try to tease out what is going on with this trend and why is it different,” Hales said.

Overall, Hales said because the study focused more on the changes themselves than the reasons for the results, there are many possible explanations that later studies could research. 

More autism diagnoses

Autism, a complex condition that has no definitive cause, is increasing among children, according to a recent New Jersey CDC study.

Dr. Walter Zahorodny, a pediatric psychologist and associate professor in the department of pediatrics at Rutgers New Jersey Medical School, led the study. He said the results showed 1 in 59 children are affected by autism, an increase from the previously recorded 1 in 68 children.

“To me, it’s a significant change because it indicates that, in a short period of time, the prevalence of autism increased 19 percent,” Zahorodny said. “That’s quite meaningful.”

The network estimate is based on data from multiple sights generating different prevalence estimates that are all increasing, Zahorodny said. There may still be some confusion on the interpretation of the data due to the size of the increase in different states, according to Zahorodny, but in New Jersey, the rates are unambiguously up.

Unfortunately, the study only focused on the number of diagnoses, not the reasons behind them, so there is not much lead as to why more children are being diagnosed with the condition. Zahorodny said experts have been trying to understand, but so far, it seems like no factor has emerged that has a strong enough effect that would be reflected in trend increases of this scope.

Zahorodny said there is no sign this trend will decrease or that autism levels have reached their peak, so he reinforced CDC recommendations for universal autism screenings for children 18 to 24 months old. The tests used for such procedures have improved over time, but he said there is more work that could be done.

“There’s still room for improvement,” Zahorodny said. “One would hope, as we go forward, there’ll be additional autism screeners, which will be shown to be more sensitive to detecting autism and more specific in not having false positives.”