TY - JOUR
T1 - Socioeconomic status and the likelihood of antibiotic treatment for signs and symptoms of pulmonary exacerbation in children with cystic fibrosis
AU - Schechter, Michael S.
AU - McColley, Susanna A.
AU - Regelmann, Warren
AU - Millar, Stefanie J.
AU - Pasta, David J.
AU - Wagener, Jeffrey S.
AU - Konstan, Michael W.
AU - Morgan, Wayne J.
PY - 2011/11
Y1 - 2011/11
N2 - Objective: To determine whether socioeconomic status (SES) influences the likelihood of antibiotic treatment of pulmonary exacerbations in patients with cystic fibrosis (CF). Study design: We used data on 9895 patients ≤18 years old from the Epidemiologic Study of CF. After establishing an individual baseline of clinical signs and symptoms, we ascertained whether antibiotics were prescribed when new signs/symptoms suggested a pulmonary exacerbation, adjusting for sex, presence of Pseudomonas aeruginosa, the number of new signs/symptoms, and baseline disease severity. Results: In a 12-month period, 20.0% of patients <6 years of age, 33.8% of patients 6 to 12 years of age, and 41.4% of patients 13 to 18 years of age were treated with any (oral, intravenous (IV), or inhaled) antibiotics; the percentage receiving IV antibiotics was 7.3%, 15.2%, and 20.9%, respectively. SES had little effect on treatment for pulmonary exacerbation with any antibiotics, but IV antibiotics were prescribed more frequently for patients with lower SES. Conclusions: SES-related disparities in CF health outcomes do not appear to be explained by differential treatment of pulmonary exacerbations.
AB - Objective: To determine whether socioeconomic status (SES) influences the likelihood of antibiotic treatment of pulmonary exacerbations in patients with cystic fibrosis (CF). Study design: We used data on 9895 patients ≤18 years old from the Epidemiologic Study of CF. After establishing an individual baseline of clinical signs and symptoms, we ascertained whether antibiotics were prescribed when new signs/symptoms suggested a pulmonary exacerbation, adjusting for sex, presence of Pseudomonas aeruginosa, the number of new signs/symptoms, and baseline disease severity. Results: In a 12-month period, 20.0% of patients <6 years of age, 33.8% of patients 6 to 12 years of age, and 41.4% of patients 13 to 18 years of age were treated with any (oral, intravenous (IV), or inhaled) antibiotics; the percentage receiving IV antibiotics was 7.3%, 15.2%, and 20.9%, respectively. SES had little effect on treatment for pulmonary exacerbation with any antibiotics, but IV antibiotics were prescribed more frequently for patients with lower SES. Conclusions: SES-related disparities in CF health outcomes do not appear to be explained by differential treatment of pulmonary exacerbations.
KW - CF
KW - Cystic fibrosis
KW - ESCF
KW - Epidemiologic Study of Cystic Fibrosis
KW - Forced expiratory volume in 1 second
KW - IV
KW - Intravenous
KW - MA
KW - MEA
KW - MIZ
KW - Maternal educational attainment
KW - Median household income by zip code
KW - Medicaid or state insurance
KW - SES
KW - Socioeconomic status
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U2 - 10.1016/j.jpeds.2011.05.005
DO - 10.1016/j.jpeds.2011.05.005
M3 - Article
C2 - 21705017
AN - SCOPUS:80053359109
SN - 0022-3476
VL - 159
SP - 819-824.e1
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 5
ER -