Association between paediatric antibiotic prescribing and socioeconomic deprivation: insights from a pilot project in West Yorkshire, United Kingdom

Background Inappropriate antibiotic use in settings including human and veterinary medicine and a lack of novel therapies have contributed to a global antimicrobial resistance (AMR) crisis. In January 2025, the UK Health Security Agency revised the UK Access, Watch, Reserve (AWaRe) antibiotic list to guide prescribing of 90 antibiotics. This pilot study investigated relationships between socioeconomic deprivation and paediatric antibiotic prescribing in secondary care in the Mid Yorkshire Teaching NHS Trust region, UK. Methods Retrospective antibiotic prescribing data was obtained from the NHS Trust’s electronic prescribing system for patients aged 0–2 years prescribed systemic antibiotics between April 2022 and January 2025, the start of the Born and Bred in Wakefield (BaBi) Wakefield project. Demographic data retrieved from electronic clinical and management information system included ethnicity, admission and discharge date, ICD-10 diagnostic codes, and IMD decile, converted to quintile for statistical analysis. Quasi-Poisson count regression approach was used to explore the relationship between the rate of antibiotic prescription, socioeconomic deprivation, and region. Results A total of 780 patients and 2204 antibiotic prescriptions were identified from hospital prescribing report. Adjusted models identified four key findings. Firstly, length of stay (LOS) in hospital and number of diagnostic codes were highest in the most deprived group (Q1). Secondly, the number of unique antibiotics prescribed (adjusted per admission) was highest in the least deprived group(Q5) although this relationship was not statistically significant. Thirdly, the number of unique antibiotics (adjusted per LOS) was highest in Q5, and this was statistically significant (p = xxx). Finally, in contrast with other studies in the UK, ethnicity was not significantly associated with the use of systemic antibiotics. Conclusion Our findings suggest that children from more deprived areas with more comorbidities/ diagnosis received less antibiotics in secondary care settings compared with their peers from least deprived areas. The LOS and number of diagnostic codes also decreased from Q1 to Q5. Future prescribing trends among children aged 0-2years should account for contextual factors to ensure that children from the most deprived communities are not disproportionately exposed to less antibiotics despite of suffering more comorbidities.