Relative Prevalence of Off-label Systemic Drug Orders by Drug Class and Age for Children in US Ambulatory Settings (2006–2015)
| Drug Classa . | Percentage of Orders That Were Off Label (95% CIs) . | |||||
|---|---|---|---|---|---|---|
| Age <1 mo . | Age 1 mo to <2 y . | Age 2–5 y . | Age 6–11 y . | Age 12–17 y . | All Children . | |
| Anti-infective | 86.3b (57.2–96.7) | 33.9 (30.6–37.2) | 33.2 (31.0–35.5) | 36.9 (34.1–39.7) | 43.6 (40.5–46.8) | 36.9 (35.2–38.6) |
| Respiratory | 100b (ND) | 85.2 (80.9–88.7) | 41.0 (37.6–44.5) | 36.7 (33.5–40.1) | 40.8 (37.7–44.0) | 44.3 (42.3–46.4) |
| Nervous | 50.5b (24.1–76.6) | 11.4 (7.3–17.4) | 19.3 (16.0–23.1) | 31.2 (28.6–34.0) | 49.2 (46.8–51.6) | 35.2 (33.3–37.2) |
| Alimentary | 98.8 (91.5–99.8) | 72.9 (67.3–77.8) | 84.1 (78.6–88.5) | 73.8 (67.7–79.1) | 52.9 (46.0–59.7) | 70.0 (65.9–73.7) |
| Hormonal | NDb | 64.9 (56.7–72.2) | 47.4 (40.6–54.3) | 34.7 (28.6–41.4) | 36.1 (28.2–44.9) | 43.5 (39.5–47.6) |
| Cardiovascular | 100b (ND) | 11.1b (8.3–14.8) | 5.7 (3.7–8.7) | 6.2 (4.6–8.5) | 11.0 (8.8–13.6) | 8.7 (7.4–10.1) |
| Musculoskeletal | 2.7b (0.1–35.6) | 42.5 (24.1–63.3) | 86.1 (69.5–94.4) | 30.9 (23.4–39.5) | 38.7 (30.3–47.7) | 39.0 (32.8–45.6) |
| Genitourinary | NDb | 100b (ND) | 86.5b (41.7–98.3) | 42.5b (19.2–69.7) | 68.8 (61.9–74.9) | 67.7 (61.3–73.5) |
| Drug Classa . | Percentage of Orders That Were Off Label (95% CIs) . | |||||
|---|---|---|---|---|---|---|
| Age <1 mo . | Age 1 mo to <2 y . | Age 2–5 y . | Age 6–11 y . | Age 12–17 y . | All Children . | |
| Anti-infective | 86.3b (57.2–96.7) | 33.9 (30.6–37.2) | 33.2 (31.0–35.5) | 36.9 (34.1–39.7) | 43.6 (40.5–46.8) | 36.9 (35.2–38.6) |
| Respiratory | 100b (ND) | 85.2 (80.9–88.7) | 41.0 (37.6–44.5) | 36.7 (33.5–40.1) | 40.8 (37.7–44.0) | 44.3 (42.3–46.4) |
| Nervous | 50.5b (24.1–76.6) | 11.4 (7.3–17.4) | 19.3 (16.0–23.1) | 31.2 (28.6–34.0) | 49.2 (46.8–51.6) | 35.2 (33.3–37.2) |
| Alimentary | 98.8 (91.5–99.8) | 72.9 (67.3–77.8) | 84.1 (78.6–88.5) | 73.8 (67.7–79.1) | 52.9 (46.0–59.7) | 70.0 (65.9–73.7) |
| Hormonal | NDb | 64.9 (56.7–72.2) | 47.4 (40.6–54.3) | 34.7 (28.6–41.4) | 36.1 (28.2–44.9) | 43.5 (39.5–47.6) |
| Cardiovascular | 100b (ND) | 11.1b (8.3–14.8) | 5.7 (3.7–8.7) | 6.2 (4.6–8.5) | 11.0 (8.8–13.6) | 8.7 (7.4–10.1) |
| Musculoskeletal | 2.7b (0.1–35.6) | 42.5 (24.1–63.3) | 86.1 (69.5–94.4) | 30.9 (23.4–39.5) | 38.7 (30.3–47.7) | 39.0 (32.8–45.6) |
| Genitourinary | NDb | 100b (ND) | 86.5b (41.7–98.3) | 42.5b (19.2–69.7) | 68.8 (61.9–74.9) | 67.7 (61.3–73.5) |
ND, not defined.
Drug class according to ATC level 1 classification.
Values are based on <30 observations.