OBJECTIVES: There has been growing attention for over-medicalization of children. We examined trends in outpatient drug use among children in the Netherlands from 2005 until 2010. METHODS: The PHARMO Record Linkage System, containing amongst others outpatient pharmacy dispensing data of ~3.2 million inhabitants in the Netherlands, was used for this study. For every year in the study period 2005-2010, the number of children aged 0-18 with a dispensing for any drug and per anatomical group was counted and extrapolated to the Netherlands, standardized for age and gender. Prevalence of use was reported per 10,000 children and was stratified by calendar year and age group. RESULTS: In all age groups, drug use increased between 2005-2008, but has been descending since. The highest increase was found among adolescents (12-18 years): drug use increased from 4,910/10,000 in 2005 to 5,496/10,000 in 2008, but declined to 5,378/10,000 in 2010. Among infants and toddlers (<2 years), use of dermatologicals, anti-infectives, respiratory drugs and drugs acting on the alimentary tract increased between 2005-2008. Since 2008, the largest decrease was found for anti-infectives and respiratory drugs (-236 and -136/10,000, respectively). Among children (2-11 years), use of dermatologicals, neurologicals and drugs acting on the alimentary tract increased between 2005-2008, while use of anti-infectives decreased (-192/10,000). Between 2008-2010, use of anti-infectives kept decreasing (-224/10,000). Among adolescents, drug use increased for all anatomical groups between 2005-2008, with the highest increase for drugs acting on the alimentary tract, respiratory drugs, dermatologicals and neurologicals. Between 2008-2010, use of neurologicals and drugs acting on the alimentary tract kept increasing, while use of anti-infectives decreased (-138/10,000). CONCLUSIONS: Drug use increased between 2005 and 2008, especially among adolescents, but has been descending since. A substantial increase in use was observed for drugs acting on the alimentary tract, dermatologicals and neurologicals, while the use of anti-infectives decreased over time.