Common respiratory illnesses such as otitis media account for approximately three-quarters of all outpatient antibiotic prescriptions for US children.1,2  Unfortunately, a large fraction of those prescriptions are unnecessary.2,3  Over the last 2 decades, efforts to address this problem of overprescribing led to roughly a 25% drop in antibiotics prescribed per child. Considering that, in the United States in 1990, children received 1.5 antibiotic prescriptions per year per child, the public health benefits of this drop are enormous. It is a success story that has not received the attention it deserves.

While the medical community should be proud of this success, the article by Vaz et al in this issue of Pediatrics provides an important cautionary note, Consistent with other work, the authors found that the trend of decreasing antibiotic prescribing has stalled in 3 health systems. They also identified persistent and...

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