Longitudinal trends of and factors associated with inappropriate antibiotic prescribing for non-bacterial acute respiratory tract infection in Japan: A retrospective claims database study, 2012–2017


Autoři: Yuki Kimura aff001;  Haruhisa Fukuda aff001;  Kayoko Hayakawa aff001;  Satoshi Ide aff003;  Masayuki Ota aff003;  Sho Saito aff003;  Masahiro Ishikane aff001;  Yoshiki Kusama aff001;  Nobuaki Matsunaga aff001;  Norio Ohmagari aff001
Působiště autorů: AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan aff001;  Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan aff002;  Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223835

Souhrn

Background

Inappropriate antibiotic prescribing is a cause of antimicrobial resistance. Acute Respiratory Tract Infections (ARTI) are common diseases for those antibiotics are most likely prescribed in outpatient setting.

Objectives

To clarify factors associated with antibiotic prescribing for non-bacterial acute respiratory tract infections (NB-ARTI) and identify targets for reducing inappropriate prescribing for NB-ARTI in Japan.

Methods

We conducted a retrospective, observational study using longitudinal claims data between April 2012 and June 2017. We assessed the rate of and factors associated with inappropriate antibiotic prescribing in outpatient settings for all NB-ARTI consultations included in the database.

Results

The mean monthly antibiotic prescribing rate per 100 NB-ARTI consultations during the study period was 31.65. The monthly antibiotic prescribing rate per 100 NB-ARTI consultations decreased by 19.2% from April 2012 to June 2017. Adolescents (13–18 years) and adults of working age (19–29 and 30–39 years) were more likely prescribed antibiotics compared with elderly patients ≥ 60 years (aOR: 1.493 [95%CI: 1.482–1.503], 1.585 [95%CI: 1.575–1.595], and 1.507 [95%CI: 1.498–1.516], respectively). Outpatient clinics registered as internal medicine or ear, nose, and throat specialty were more likely to prescribe antibiotics than those of paediatric specialty or other specialties. Among health facility type, clinics without beds (aOR 2.123 [95%CI: 2.113–2.133]) and clinics with beds (aOR: 1.752 [95%CI: 1.7371–1.767]) prescribed significantly more antibiotics for NB-ARTI than outpatient departments inside general hospitals.

Conclusions

Inappropriate antibiotic prescribing for NB-ARTI is common in Japan. Although the antibiotic prescribing rate has decreased, further interventions are required to promote antimicrobial stewardship (ASP). Education and awareness for adults and promotion of ASP among physicians in clinics without beds are key drivers to reduce inappropriate antibiotic prescribing in Japan.

Klíčová slova:

Age groups – Antibiotics – Antimicrobials – Bronchitis – Japan – Outpatients – Pediatrics – Respiratory infections


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2019 Číslo 10