Antimicrob Stwrd Hlth Epidem

More vaccines, fewer scripts: Pediatric antibiotic use drops 47% over two decades

July 17, 2025

Between 2000 and 2019, outpatient antibiotic prescribing for U.S. children under age 5 dropped nearly in half, from 1.89 to 1.01 per person-year—while vaccine coverage more than doubled. The most dramatic reductions were seen in macrolide use (down 73%) and broad-spectrum antibiotics (down 57%).

These findings come from a large claims database study that analyzed data from over 6.7 million children. Researchers tracked trends in vaccine uptake and antibiotic prescribing, focusing on respiratory tract infections (RTIs), a major driver of pediatric antibiotic use.

Immunization rates rose from 32.5% to 66.8% for children receiving pneumococcal, Hib, influenza, and DTaP vaccines—as RTI-related antibiotic prescriptions fell, with notable declines in sinusitis and pharyngitis treatment. While the study doesn’t establish causality, the temporal association suggests that expanded vaccine coverage may have contributed to reduced infection burden and antibiotic demand.

Source:

Eiden AL, et al. (2025, July 11). Antimicrob Steward Healthc Epidemiol. Temporal trends in vaccination and antibiotic use among young children in the United States, 2000-2019. https://pubmed.ncbi.nlm.nih.gov/40657031/