Use of topical ocular antibiotics in young children: a Scandinavian drug utilization study

Purpose Acute infectious conjunctivitis is a common disease. While usually self-limiting, children often receive treatment to be accepted back into nursery, day care or school. We aimed to describe trends in the utilization of topical ocular antibiotics in young children aged 0-4 years in Denmark, Norway and Sweden. Methods Using individual-level data from the Danish National Prescription Registry (2000-2015), we provided detailed descriptions of treatment patterns at the individual level, stratified by age (0-1 years, 2-4 years) and antibiotic substance. Aggregate-level data for Danish, Norwegian and Swedish children (0-4 years) were obtained from publicly available data sources (2000-2016). Results We identified 107 581 Danish children aged 0-4 years receiving 271 980 treatment episodes. The incidence rate was relatively stable between 2000 and 2010 (on average, 637 and 283/1000 person-years for 0- to 1- and 2- to 4-year-olds, respectively), after which it dropped by 37% until 2015. In the aggregated data, a markedly higher use was seen in Denmark (211/1000 children in 2016) compared with Sweden (42) and Norway (151). The decrease from 2010 onwards was observed in all three countries. Chloramphenicol and fusidic acid were the most commonly used topical ocular antibiotics across Scandinavia. Tobramycin was rarely used in Norway and Sweden (<= 1/1000 children in 2016) compared with Denmark (24/1000 children). Conclusion Considerable variation is seen in the utilization of topical ocular antibiotics among children in Scandinavia, with Denmark having the highest use. Across the Scandinavian countries, however, a decline was noted from 2010 onwards.