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Of the 10,018,066 systemic antibacterial claims selected for analysis, antibacterial prescribing rates decreased from 542 claims\/1000 beneficiaries in 2006 to 461 claims\/1000 beneficiaries in 2011 (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.971, p=0.0012; \u03c4\u2010b\u00a0=\u00a0\u22121.00, p=0.009). Among age groups, children had the highest rate of use (605 claims\/1000 beneficiaries, \u03c7<jats:sup>2<\/jats:sup> (2)\u00a0=\u00a0320,000, p&lt;0.001); among racial\/ethnic groups, Alaskan Natives and Native Americans had the highest rate of use (1086\/1000 beneficiaries, \u03c7<jats:sup>2<\/jats:sup> (5)\u00a0=\u00a0197,000, p&lt;0.001). Broad\u2010spectrum antibacterial prescribing increased from 28.1% (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 28.1\u201328.2%) to 32.7% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 32.6\u201332.8%) over the study period. Senior age groups and whites received the highest proportions of broad\u2010spectrum agents (53.4% [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 52.5\u201354.3%] and 36.6% [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 36.6\u201336.7%], respectively). Population density was inversely related to both overall antibacterial use (\u03c1\u00a0=\u00a0\u22120.432, p=0.0018) and broad\u2010spectrum antibacterial prescribing (\u03c1\u00a0=\u00a0\u22120.359, p&lt;0.001). The rate of prescribing decreased over the study period for all antibacterial classes with the exception of macrolides and sulfonamides. Amoxicillin was the most frequently prescribed agent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Overall and broad\u2010spectrum antibacterial use in the Medi\u2010Cal fee\u2010for\u2010service program are less than that observed nationally. Significant variations in prescribing exist between age and racial\/ethnic groups, and heavily populated areas are associated with both less antibacterial use and less broad\u2010spectrum antibacterial prescribing. Studies are needed to determine the reasons for the observed differences in antibacterial use among demographic groups.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.1425","type":"journal-article","created":{"date-parts":[[2014,4,19]],"date-time":"2014-04-19T07:16:48Z","timestamp":1397891808000},"page":"677-685","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Patterns of Antibacterial Use and Impact of Age, Race\/Ethnicity, and Geographic Region on Antibacterial Use in an Outpatient Medicaid Cohort"],"prefix":"10.1002","volume":"34","author":[{"given":"Alice M.","family":"Gahbauer","sequence":"first","affiliation":[{"name":"School of Pharmacy University of California San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco L.","family":"Gonzales","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of California San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. 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