Antibiotic prescriptions for Japanese outpatients with acute respiratory tract infections (2013–2015): A retrospective Observational Study

Koyama, Toshihiro; Hagiya, Hideharu; Teratani, Yusuke; Tatebe, Yasuhisa; Ohshima, Ayako; Adachi, Mayu; Funahashi, Tomoko; Zamami, Yoshito; Tanaka, Hiroyoshi; Tasaka, Ken; Shinomiya, Kazuaki; Kitamura, Yoshihisa; Sendo, Toshiaki; Hinotsu, Shiro; Kano, Mitsunobu R.

doi:10.1016/j.jiac.2020.02.001

Cited by 13 publications

(18 citation statements)

References 23 publications

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“…The inappropriate use of antimicrobials for acute respiratory tract infection [ 6 , 7 ] and acute infectious diarrhea, which is common in large numbers of patients [ 8 , 9 ] is an inevitable problem. These diseases are mostly caused by viruses and empirical antimicrobials are not necessary for otherwise healthy patients (here, ‘otherwise healthy’ indicates that except for acute infectious diarrhea, the patients had no other medical conditions requiring treatment), particularly in developed countries [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although several studies have examined the role of antimicrobial stewardship in acute respiratory tract infections [ 6 , 15 , 16 ], few studies have examined this issue in relation to diarrhea in Japan, excluding a database study in children [ 17 ] and in all ages [ 12 ], but both of these studies were based on data up to 2015 and did not compare data between before and after the preparation of the National Action Plan and the manual. To implement measures for national antimicrobial stewardship for acute infectious diarrhea, understanding is required of the epidemiological characteristics of and antimicrobial prescriptions for acute infectious diarrhea.…”

Section: Introductionmentioning

confidence: 99%

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Trends in healthcare visits and antimicrobial prescriptions for acute infectious diarrhea in individuals aged 65 years or younger in Japan from 2013 to 2018 based on administrative claims database: a retrospective observational study

et al. 2021

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Background The inappropriate use of antimicrobials for acute infectious diarrhea is widespread and leads to the problem of antimicrobial resistance. To improve the use of antimicrobials, it is first necessary to understand the actual situation of diarrheal disease and to identify potential targets for intervention. This study aimed to investigate the recent epidemiological characteristics of and antimicrobial prescriptions for acute infectious diarrhea in Japan. Methods This was a retrospective observational study of outpatients aged 0–65 years, separated into children (age 0–17 years) and adults (age 18–65 years), diagnosed with acute infectious diarrhea, using the administrative claims database of the Japan Medical Data Center from 2013 to 2018. We evaluated the number of eligible visits/number of database registrants (defined as the visit rate). The analysis of the antimicrobial prescription rate was restricted to otherwise healthy individuals diagnosed with acute infectious diarrhea alone by excluding patients with multiple disease diagnoses and with medical backgrounds of chronic bowel diseases or immunocompromised conditions. We further classified them by diagnosis of bacterial or nonbacterial acute infectious diarrhea. Results The total number of eligible visits for acute infectious diarrhea was 2,600,065. The visit rate, calculated based on the number of eligible visits by database registrants, was higher in children (boys, 0.264; girls, 0.229) than in adults (men, 0.070; women, 0.079), with peaks in early summer and winter. The peaks for visits in adults lagged those of children. In total, 482,484 visits were analyzed to determine the antimicrobial prescription rate; 456,655 (94.6%) were diagnosed with nonbacterial acute infectious diarrhea. Compared with children (boys, 0.305; girls, 0.304), the antimicrobial prescription rate was higher in adults, and there were differences between sexes in adults (men, 0.465; women, 0.408). Fosfomycin and fluoroquinolone were most frequently used for nonbacterial acute infectious diarrhea in children (44.1%) and adults (50.3%), respectively. Conclusions These results revealed overprescription of antimicrobials for acute infectious diarrhea in this administrative claims database in Japan and contribute to the development of antimicrobial stewardship strategies and the identification of targets for efficiently reducing inappropriate antimicrobial use.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trends in healthcare visits and antimicrobial prescriptions for acute infectious diarrhea in individuals aged 65 years or younger in Japan from 2013 to 2018 based on administrative claims database: a retrospective observational study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The inappropriate use of antimicrobials for acute respiratory tract infection [5,6] and acute infectious diarrhea, which is common in large numbers of patients [7,8] is an inevitable problem. These diseases are mostly caused by viruses and empirical antimicrobials are not necessary for otherwise healthy patients, particularly in developed countries [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…Although several studies have examined the role of antimicrobial stewardship in acute respiratory tract infections [5,12,13], few studies have examined this issue in relation to diarrhea in Japan, excluding a database study in children [14]. To implement measures for national antimicrobial stewardship for acute infectious diarrhea, understanding is required of the epidemiological characteristics of and antimicrobial prescriptions for acute infectious diarrhea.…”

Section: Introductionmentioning

confidence: 99%

Trends In Healthcare Visits And Antimicrobial Prescriptions For Acute Infectious Diarrhea In Individuals Aged 65 Years Or Younger In Japan From 2013 to 2018 Based On Administrative Claims Database: A Retrospective Observational Study

Ono

Aoyagi

Asai

et al. 2021

Preprint

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Background: The inappropriate use of antimicrobials for acute infectious diarrhea is widespread and leads to the problem of antimicrobial resistance. To improve the use of antimicrobials, it is first necessary to understand the actual situation of diarrheal disease and to identify potential targets for intervention. This study aimed to investigate the recent epidemiological characteristics of and antimicrobial prescriptions for acute infectious diarrhea in Japan.Methods: This was a retrospective observational study of outpatients aged 0–65 years, separated into children (age 0–17 years) and adults (age 18–65 years), diagnosed with acute infectious diarrhea, using the administrative claims database of the Japan Medical Data Center from 2013 to 2018. We evaluated the number of eligible visits/number of database registrants (defined as the visit rate). The analysis of the antimicrobial prescription rate was restricted to otherwise healthy individuals diagnosed with acute infectious diarrhea alone by excluding patients with multiple disease diagnoses and with medical backgrounds of chronic bowel diseases or immunocompromised conditions. We further classified them by diagnosis of bacterial or nonbacterial acute infectious diarrhea.Results: The total number of eligible visits for acute infectious diarrhea was 2,600,065. The visit rate, calculated based on the number of eligible visits by database registrants, was higher in children (boys, 0.264; girls, 0.229) than in adults (men, 0.070; women, 0.079), with peaks in early summer and winter. The peaks for visits in adults lagged those of children. In total, 482,484 visits were analyzed to determine the antimicrobial prescription rate; 456,655 (94.6%) were diagnosed with nonbacterial acute infectious diarrhea. Compared with children (boys, 0.305; girls, 0.304), the antimicrobial prescription rate was higher in adults, and there were differences between sexes in adults (men, 0.465; women, 0.408). Fosfomycin and fluoroquinolone were most frequently used for nonbacterial acute infectious diarrhea in children (44.1%) and adults (50.3%), respectively.Conclusions: These results revealed overprescription of antimicrobials for acute infectious diarrhea in this administrative claims database in Japan and contribute to the development of antimicrobial stewardship strategies and the identification of targets for efficiently reducing inappropriate antimicrobial use.

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“…Notably, almost half of all students and a quarter of finalyear students were found to have a false understanding that the antibiotics helped treat the common cold. In Japan, the overuse of antibiotics for acute respiratory infections remains in every clinical situation [11,12], indicating the importance of undergraduate education in antibiotic literacy. The AMR action plan was little known by medical students (6.5%), though it has been carried out for more than 3 years [2].…”

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confidence: 99%

Antibiotic literacy among Japanese medical students

Hagiya

Ino

Tokumasu

et al. 2020

Journal of Infection and Chemotherapy

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Antimicrobial resistance (AMR) is an urgent global issue. After the AMR action plan was introduced in 2016, a study on antibiotic literacy (i.e., awareness, knowledge, and attitude relating to antimicrobial use) among clinicians and lay people was conducted in Japan. However, no studies have hitherto targeted medical students who are expected to have a high level of antibiotic literacy. The present study was conducted between September 2019 and February 2020, enrolling undergraduate students at Okayama University Medical School. We collected data using a paper-based questionnaire form with 11 questions about antibiotic literacy. The response rate was 93.8% (661/705 students). Overall, 92.6% of the students knew that antibiotics inhibit the growth of bacteria. Student reporting that antibiotics could treat the common cold accounted for 77.0% (Year 1), 50.9% (Year 2), 48.2% (Year 3), 49.1% (Year 4), 23.8% (Year 5), and 26.2% (Year 6). Only 43 (6.5%) had heard about the AMR action plan. The study data suggested that medical students' level of literacy on antimicrobial use should be further enhanced to address AMR and promote antimicrobial stewardship.

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Antibiotic prescriptions for Japanese outpatients with acute respiratory tract infections (2013–2015): A retrospective Observational Study

Cited by 13 publications

References 23 publications

Trends in healthcare visits and antimicrobial prescriptions for acute infectious diarrhea in individuals aged 65 years or younger in Japan from 2013 to 2018 based on administrative claims database: a retrospective observational study

Trends in healthcare visits and antimicrobial prescriptions for acute infectious diarrhea in individuals aged 65 years or younger in Japan from 2013 to 2018 based on administrative claims database: a retrospective observational study

Trends In Healthcare Visits And Antimicrobial Prescriptions For Acute Infectious Diarrhea In Individuals Aged 65 Years Or Younger In Japan From 2013 to 2018 Based On Administrative Claims Database: A Retrospective Observational Study

Antibiotic literacy among Japanese medical students

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