Trend in antibiotic prescription at pediatric primary emergency medical centers in Japan: A multi-center, cross-sectional study.

Autor: Otake S; Department of Pediatrics, Kobe University Graduate School of Medicine, Hyogo, Japan; Division of Infectious Disease, Department of Pediatrics, Kobe Children's Hospital, Hyogo, Japan. Electronic address: shogo.ohtake@gmail.com., Shoji T; Department of Infectious Diseases, Shizuoka Children's Hospital, Shizuoka, Japan., Yamada K; Department of Pediatrics, University of Fukui Hospital, Fukui, Japan., Kimura M; Kobe Children's Primary Emergency Medical Center, Hyogo, Japan., Myojin S; Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan., Kamiyoshi N; Department of Pediatrics, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan., Ochi F; Department of Pediatrics, Ehime Prefectural Niihama Hospital, Ehime, Japan., Nezu M; Department of Clinical Epidemiology, Hyogo Medical University, Hyogo, Japan., Ishida A; Kobe Children's Primary Emergency Medical Center, Hyogo, Japan., Miyairi I; Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan; Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, TN, USA., Kasai M; Division of Infectious Disease, Department of Pediatrics, Kobe Children's Hospital, Hyogo, Japan.
Jazyk: angličtina
Zdroj: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy [J Infect Chemother] 2024 Jul; Vol. 30 (7), pp. 616-620. Date of Electronic Publication: 2024 Jan 17.
DOI: 10.1016/j.jiac.2024.01.009
Abstrakt: Introduction: Antimicrobial resistance is a global issue, and implementation of antimicrobial stewardship programs in outpatient settings is crucial. Japan has also focused on outpatient oral antimicrobial stewardship programs and difficulties in standardizing prescriptions have led to overprescription in primary emergency medical centers. There is a lack of research investigating the antibiotic prescription status of pediatric primary emergency medical centers and the benchmark prescription rates in pediatric outpatient settings.
Methods: We conducted a multi-center, cross-sectional study of seven pediatric primary emergency medical centers located in five prefectures of Japan. We retrospectively extracted data from health claims or directly obtained them from charts at each institution and evaluated trends in the antibiotic prescription rate based on the AWaRe classification between April 2016 and December 2019.
Results: Our study included 383,525 encounters, with the most common infectious disease diagnosis being acute upper respiratory tract infection in 93,449 cases (24.4 %). The antibiotic prescription rate during the study period was 7.4 %, representing a decrease of 46 %, from 10.2 % in 2016 to 5.5 % in 2019. The percentage of prescriptions in the Access group increased at all institutions; however, it exceeded 60 % in only three facilities in 2019. The percentage of third-generation cephalosporins varied among facilities, ranging from 1.7 % to 59.4 %, as of 2019.
Conclusions: For pediatric primary emergency medical centers where antimicrobial stewardship programs are implemented, we suggest 5 % as a reasonable benchmark level for the antibiotic prescription rate. Prescribing the antibiotics in the Access groups less frequently remains a domestic challenge in Japan.
Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest to disclose. Informed Consent and Ethical Approval. We obtained opt-out consent from the patients' parents. This study was approved by the institutional ethics committees of Kobe Children's Hospital (Approval Number 2021–61).
(Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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