In pediatric outpatient care the topic of antibiotic stewardship (ABS) has gained increasing interest over the last 10 years. The German Central Institute of the Association of Statutory Health Insurance Physicians regularly analyzes national antibiotic prescription rates (APR) according to §300 paragraph 2 Social Act 5 (SGB V, statutory insured persons). The most recent analysis (2010–2019) showed marked reductions of the APR in children and adolescents (0–14 years) per 1000 insured persons, particularly in infants (∆ −53%) and toddlers (∆ −46%). From an ABS perspective, oral cephalosporins (e.g. cefaclor and cefuroxime) still account for a too high proportion of all prescriptions. In addition, there are striking regional differences that cannot be explained by differences in the patient population or the spectrum of diseases.