Socioeconomic status and the likelihood of antibiotic treatment for signs and symptoms of pulmonary exacerbation in children with cystic fibrosis

Michael S. Schechter, Susanna A. McColley, Warren Regelmann, Stefanie J. Millar, David J. Pasta, Jeffrey S. Wagener, Michael W. Konstan, Wayne J Morgan

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalThe Journal of Pediatrics
Volume159
Issue number5
DOIs
StatePublished - Nov 2011

Fingerprint

Cystic Fibrosis
Social Class
Signs and Symptoms
Anti-Bacterial Agents
Lung
Therapeutics
Pseudomonas aeruginosa
Epidemiologic Studies
Health

Keywords

  • CF
  • Cystic fibrosis
  • Epidemiologic Study of Cystic Fibrosis
  • ESCF
  • FEV
  • Forced expiratory volume in 1 second
  • Intravenous
  • IV
  • MA
  • Maternal educational attainment
  • MEA
  • Median household income by zip code
  • Medicaid or state insurance
  • MIZ
  • SES
  • Socioeconomic status

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Socioeconomic status and the likelihood of antibiotic treatment for signs and symptoms of pulmonary exacerbation in children with cystic fibrosis. / Schechter, Michael S.; McColley, Susanna A.; Regelmann, Warren; Millar, Stefanie J.; Pasta, David J.; Wagener, Jeffrey S.; Konstan, Michael W.; Morgan, Wayne J.

In: The Journal of Pediatrics, Vol. 159, No. 5, 11.2011.

Research output: Contribution to journalArticle

Schechter, Michael S. ; McColley, Susanna A. ; Regelmann, Warren ; Millar, Stefanie J. ; Pasta, David J. ; Wagener, Jeffrey S. ; Konstan, Michael W. ; Morgan, Wayne J. / Socioeconomic status and the likelihood of antibiotic treatment for signs and symptoms of pulmonary exacerbation in children with cystic fibrosis. In: The Journal of Pediatrics. 2011 ; Vol. 159, No. 5.
@article{02226711cdf6406c9c1a3c980c84d66d,
title = "Socioeconomic status and the likelihood of antibiotic treatment for signs and symptoms of pulmonary exacerbation in children with cystic fibrosis",
abstract = "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.",
keywords = "CF, Cystic fibrosis, Epidemiologic Study of Cystic Fibrosis, ESCF, FEV, Forced expiratory volume in 1 second, Intravenous, IV, MA, Maternal educational attainment, MEA, Median household income by zip code, Medicaid or state insurance, MIZ, SES, Socioeconomic status",
author = "Schechter, {Michael S.} and McColley, {Susanna A.} and Warren Regelmann and Millar, {Stefanie J.} and Pasta, {David J.} and Wagener, {Jeffrey S.} and Konstan, {Michael W.} and Morgan, {Wayne J}",
year = "2011",
month = "11",
doi = "10.1016/j.jpeds.2011.05.005",
language = "English (US)",
volume = "159",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "5",

}

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 - Epidemiologic Study of Cystic Fibrosis

KW - ESCF

KW - FEV

KW - Forced expiratory volume in 1 second

KW - Intravenous

KW - IV

KW - MA

KW - Maternal educational attainment

KW - MEA

KW - Median household income by zip code

KW - Medicaid or state insurance

KW - MIZ

KW - SES

KW - Socioeconomic status

UR - http://www.scopus.com/inward/record.url?scp=80053359109&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053359109&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2011.05.005

DO - 10.1016/j.jpeds.2011.05.005

M3 - Article

C2 - 21705017

AN - SCOPUS:80053359109

VL - 159

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 5

ER -