Targets for Optimizing Oral Antibiotic Prescriptions for Pediatric Outpatients in Japan

Japanese journal of infectious diseases

Yuho Horikoshi¹  Masashi Kasai²  Kazuhiro Uda³  Isao Miyairi⁴  Noriko Kinoshita⁵  Naho Morisaki⁶ 

[1] Department of Social Medicine, Research Institute, National Center for Child Health and Development;Disease Control and Prevention Center, National Center for Global Health and Medicine;Division of Infectious Diseases, Department of Medical Subspecialties, Research Institute, National Center for Child Health and Development;Division of Infectious Diseases, Department of Pediatrics, Hyogo Prefectural Kobe Children Hospital;Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center

关键词: antimicrobial resistance;    antimicrobial stewardship program;    child;    days of therapy;    outpatient;   

DOI  :  10.7883/yoken.JJID.2018.374

学科分类：传染病学

来源: National Institute of Infectious Diseases

【 摘 要 】

In Japan, 92.6% of antibiotics consumed are oral agents; most of these are for outpatients. A significant proportion is known to be dispensed for children; however, the specific pattern of antibiotic prescription in accordance with clinical specialty is still unclear. The aim of our study was to identify the key targets for the optimization of oral antibiotic use in children. We analyzed data on oral antimicrobial prescription patterns for children ＜ 16 years old of age in 3 urban districts by using a national database in Japan. Oral prescriptions were categorized according to their class, spectrum, clinical specialty, and type of clinical setting. The antibiotic spectrum was categorized as narrow, broad, or ultra-broad. In total, 132,869,332 antibiotic prescriptions were collected for analysis. The proportions of narrow-spectrum, broad-spectrum, and ultra-broad-spectrum antibiotics were 10.9%, 73.7%, and 15.4% in primary care clinics and 23.4%, 71.1%, and 5.4% in hospitals, respectively. Prescriptions from pediatricians and otolaryngologists in primary care clinics were predominant in the 3 studied areas. Third-generation cephalosporins, quinolones, penems, and carbapenems were prescribed mostly by pediatricians and otolaryngologists. Ultra-broad spectrum antibiotics used in primary care clinics and antibiotics particular to each specialty were identified as key targets for the optimization of oral antibiotic use for pediatric outpatients.

【 授权许可】

Unknown