A nationwide questionnaire survey of clinic doctors on antimicrobial stewardship in Japan

Gu, Yoshiaki; Fujitomo, Yumiko; Soeda, Hiroshi; Nakahama, Chikara; Hasegawa, Naoki; Maesaki, Shigefumi; Maeda, Masako; Matsumoto, Tetsuya; Miyairi, Isao; Ohmagari, Norio

doi:10.1016/j.jiac.2019.12.005

Cited by 22 publications

(28 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most important reason may be that doctors were either unaware of the manual (42.2%) or did not use it if they were aware of the manual (43.7%), according to a previous survey of Japanese clinic doctors. 19 Qualitative studies showed that trying to meet patient expectations was a major factor for physicians and that pressure from patients, relatives, or carers was an uncomfortable influence on prescribing decisions. [19][20][21][22][23] One of the studies also identified other possible factors, including limited time, poor doctor-patient communication, and diagnostic uncertainty.…”

Section: Discussionmentioning

confidence: 99%

“…19 Qualitative studies showed that trying to meet patient expectations was a major factor for physicians and that pressure from patients, relatives, or carers was an uncomfortable influence on prescribing decisions. [19][20][21][22][23] One of the studies also identified other possible factors, including limited time, poor doctor-patient communication, and diagnostic uncertainty. 22 Another factor may be direct marketing strategies by pharmaceutical industries toward prescribing physicians.…”

Section: Discussionmentioning

confidence: 99%

“…A recent survey of clinics in Japan reported that physicians in clinics were unaware of the manual (42.2%) and the national action plan (44.9%), but they were aware of the effect of appropriate antimicrobial use on the prevention of antimicrobial resistance (82.1%). 19 Thus, continuous education and recommendations to physicians is important. Third, according to a nationwide survey of the general population in Japan,~30% of respondents preferred physicians who prescribed antibiotics for a cold.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of national guidelines for antimicrobial stewardship to reduce antibiotic use in upper respiratory tract infection and gastroenteritis

Sato

Goto

Uda

et al. 2020

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

Objective: To examine whether the issue and dissemination of national guidelines in the Manual of Antimicrobial Stewardship had an impact on reducing antibiotic use for acute respiratory tract infection (ARTI) and gastroenteritis. Method: An interrupted time-series analysis was performed using a large nationwide database from June 2016 to June 2018. Outpatients with ARTI or gastroenteritis aged ≥6 years were identified. The outcome measures were any antibiotic use and broad-spectrum antibiotic use. The season-adjusted changes in the rate of antibiotic prescriptions for 2 periods before and after the guideline issue date were examined. Results: There were 13,177,735 patients with ARTI and 300,565 patients with gastroenteritis during the study period. Among patients with ARTI, there was a significant downward trend in antibiotic use during the 2-year study period (−0.06% per week; 95% CI, −0.07% to −0.04%). However, there was no significant change in trends of antibiotic use between the pre-issue period and post-issue period (trend difference, −0.01% per week; 95% CI, −0.10% to 0.07%). Similarly, for patients with gastroenteritis, there was no significant change in the trends of antibiotic use between the pre-issue period and post-issue period (trend difference, −0.02% per week; 95% CI, −0.04% to 0.01%). Similar associations were observed in analyses for broad-spectrum antibiotic use. Conclusions: Despite the issue of national guidelines to promote the appropriate use of antibiotics, there were no significant changes in trends of antibiotic use for outpatients with ARTI or gastroenteritis between the pre-issue and post-issue periods.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of national guidelines for antimicrobial stewardship to reduce antibiotic use in upper respiratory tract infection and gastroenteritis

Sato

Goto

Uda

et al. 2020

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…Such misconceptions can trigger inappropriate antibiotic use; some people may consult physicians just to request antibiotics (available on prescription only in Japan) for the common cold or may keep leftover antibiotics for later use themselves or to share with family members. According to a recent survey of doctors in clinics in Japan [4], half of the participants (50.4%) answered that they would prescribe antibiotics for the common cold if, regardless of explanation, patients were not convinced of the ineffectiveness of antibiotics for the condition. This highlights the importance of both AMR awareness campaigns for the general public and educational programmes for doctors.…”

Section: Exploring Effective Awareness Campaignmentioning

confidence: 99%

Raising awareness of antimicrobial resistance: comment on ‘Reducing expectations for antibiotics in primary care: a randomised experiment to test the response to fear based messages about antimicrobial resistance’

2020

BMC Med

Self Cite

View full text Add to dashboard Cite

“…The common cold is an acute viral respiratory tract infection in which symptoms of all three areas, namely, nasal symptoms (nasal discharge, nasal congestion), pharyngeal symptoms (pharyngalgia) and lower respiratory tract symptoms (cough, sputum) present "simultaneously" and "at a similar level", regardless of whether pyrexia is present or not. in February last year, and 50.4% of the respondents stated that when a patient with a common cold or his/her family requests an antibiotic to be prescribed, "I would prescribe (an antibiotic) if they are not convinced by my explanation" (9). There is also a study that revealed that physicians tend to feel that "the patient wishes to receive an antibiotic" when a patient is not convinced by the treatment options the physician offers.…”

Section: Background and Outline Of The Ministry Of Health Labour Andmentioning

confidence: 99%

National Action Plan on Antimicrobial Resistance (AMR) 2016-2020 and relevant activities in Japan

Ohmagari

2019

GHM

Self Cite

View full text Add to dashboard Cite

includes "International Cooperation" as a unique 6th pillar additionally set in reference to the 5 pillars of the Global Action Plan, and a goal, strategy and countermeasures have been set for each area (Figure 1). Current status and challenges of antibiotic treatment in Japan The use of antibiotics in Japan is not particularly higher compared to that in Europe or the USA. However, in Japan oral antibiotics account for 92.4% of the total daily usage, and consists of third generation cephalosporins, macrolides and fluoroquinolone derivatives, which are so-called broad-spectrum antibiotics. Therefore, it is considered that the problem in Japan is the use of such broad-spectrum oral antibiotics (1). Higashi, et al. examined the national prescription database for the period from January to March 2005 and reported that approximately 60% of patients with non-bacterial upper respiratory tract infections were given antibiotics. The breakdown of the prescriptions was third generation cephalosporins (46%), macrolides (27%) and quinolones (16%) in descending order of frequency, and were prescribed more often at clinics than hospitals (2). Antibiotics may be prescribed to patients with the common cold for the purpose of pneumonia prophylaxis. Regarding this, a study was conducted to investigate how many patients with acute respiratory tract infection, including those with the common cold, need to be treated with antibiotics to prevent one patient from developing complications including pneumonia (3). The results showed that one case of complications could be prevented if 4,000 patients with acute respiratory tract infection would be given antibiotics. Considering the cost of antibiotics prescribed to 4,000 patients and the risks of adverse drug reactions and resistant bacteria, the prophylactic use of antibiotics to (71)

show abstract

A nationwide questionnaire survey of clinic doctors on antimicrobial stewardship in Japan

Cited by 22 publications

References 19 publications

Impact of national guidelines for antimicrobial stewardship to reduce antibiotic use in upper respiratory tract infection and gastroenteritis

Impact of national guidelines for antimicrobial stewardship to reduce antibiotic use in upper respiratory tract infection and gastroenteritis

Raising awareness of antimicrobial resistance: comment on ‘Reducing expectations for antibiotics in primary care: a randomised experiment to test the response to fear based messages about antimicrobial resistance’

National Action Plan on Antimicrobial Resistance (AMR) 2016-2020 and relevant activities in Japan

Contact Info

Product

Resources

About