[Geographic variability in prescribing antibiotics in the pediatric population of Castille and León during 2001-2005].

The aim of this study was to determine if there were differences in the antibiotic consumption among the pediatric population of the eleven Primary Health Care centers in the Community of Castilla Leon during the years 2001-2005 and to analyze the possible causes. Data of non-hospital antibiotic consumption in the pediatric population provided the amount of antibiotics billed in the Health Service of the area of Castilla and Leon (central region of Spain). The data was analyzed according to the Anatomic Therapeutic Chemical Classification System (ATC) and expressed as defined daily doses per 1000 inhabitants per day (DID). There were statistically significant differences in the use of antibiotics, varying 8.3 DID between the area with the highest rate (24.86 DID in Leon) and the area with the lowest rate (16.56 DID in Soria). The temporal fluctuations were great and varied especially in Segovia. The pattern of prescribing also varied. The use of penicillin in combination with beta-lacatamase inhibitors varied by a factor of almost three times between Burgos and Segovia. Segovia showed the best management in antibiotic prescriptions with data showing low consumption based on prescribing recommendations. Data from Soria showed low consumption but patterns of misuse in regard to protocols and prescribing. There was wide quantitative and qualitative variability of antibiotic use among the primary health care centers in the region of Castilla and Leon. More detailed studies by age groups, welfare pressure and indication are needed to better understand the determinants of antibiotic use in children.