Prevalence and patterns of anti-infective medication use in children with type 1 diabetes mellitus

Background: Antiinfective medications are among the most commonly used classes of medicines in patients with Type1 Diabetes Mellitus (T1DM). Quantitative data of the prevalence and patterns of use of these drugs in children with T1DM are limited. Objectives: To determine prevalence and patterns of antiinfective drug use in T1DM children in the Netherlands. Methods: A population-based cohort study was conducted in the Dutch PHARMO Record Linkage System that comprises community pharmacy dispensing records linked to hospital admissions. All patients (<19 year) with at least two insulin prescriptions between January 1999 and December 2009 (T1DM cohort) and a four times larger reference cohort with the same age and sex distribution, but without antidiabetic prescriptions were identified from PHARMO. Both cohorts were followed from the index date (first insulin prescription date) for 4 years. The period prevalence of antiinfective drug use (antibacterials, antimycotics, antimycobacterials, antivirals, and antifungals) in T1DM and reference cohorts was calculated by dividing the number of patients with at least one antiinfective prescription by the number of patients available in the cohort during the follow up time. Prevalence in the T1DM cohort was stratified by sex and age (0-5, 6-12, and 13-18 years) and year of follow up. Results: A total number of 925 T1DM patients and 3,591 children in the reference cohort (49.3% females, mean age 10.1 years) met the inclusion criteria. The period prevalence of antiinfective drug use in T1DM was significantly higher than in the reference cohort with 63% vs. 53% (p = 0.000). Female T1DM patients had a higher prevalence of antiinfective use with 66% vs. 59% in male T1DM (p = 0.024). Zero to 5 year old T1DM patients had the highest prevalence of antiinfective use with 77%, this number was followed by 64% in 13-18 year and 56% in 6-12 year (p = 0.000). The highest prevalence was observed in the T1DM patients in the first year of diabetes with 35.5%. Conclusions: T1DM children consume antiinfective medications significantly more than a reference cohort. There were differences in the prevalence of antiinfective drug use in different genders and age groups.