Children with Medical Complexity Have High Rates of Outpatient Antibiotic Prescription, Study FInds

As the conditions become more complex, antibiotic prescription rate rises, and children with three or more complex conditions have the highest annual antibiotic prescription rate of any population.

Matt MacKenzie

April 28, 2026

Key Highlights

- 39.3% of children in the study filled at least one antibiotic prescription during 2023.
- Prescription rates increased from 514 per 1,000 children in healthy kids to 2,882 in those with three or more CCCs.
- Children with multiple chronic conditions are more likely to receive broad-spectrum antibiotics, indicating potential overuse.
- The findings highlight the urgent need for improved antibiotic stewardship in pediatric healthcare, especially for medically complex children.
- This research emphasizes the importance of tailored interventions to reduce unnecessary antibiotic exposure in vulnerable pediatric populations.

A new study of children enrolled in Medicaid found a “high rate of outpatient antibiotic use in kids with medical complexity.” CIDRAP has the news.

The researchers examined “outpatient antibiotic claims in more than 2.3 million children ages 0 to 18 years who were enrolled in Medicaid in 2023. They categorized the children into five groups—healthy; non-complex chronic condition; and one, two, and three or more complex chronic conditions (CCCs)—and compared antibiotic prescribing rates across groups.”

39.3% of the children included in the analysis filled “one or more antibiotic prescriptions during the study period.” Annual prescription rates rose across the groups as the level of medical complexity increased, “rising from 514 in healthy children to 2,882 in children with three or more CCCs. Children with medical complexity were also far more likely to be prescribed broad-spectrum antibiotics.”

The researchers also said that “children with three or more CCCs have the highest annual antibiotic prescription rate of any population, pediatric or adult.”