The Prescription of Oral Antibiotics for Acute Respiratory Tract Infection in Pediatric Outpatients at Acute Diagnosis Procedure Combination Hospitals (2013-2018)

Abstract

Antimicrobial resistance (AMR) has become one of the biggest health threats across the world, and AMR action plan was launched in Japan in April, 2016. The importance of appropriate antibiotic use was mentioned in the plan, and one of the goals is to reduce the use of oral antibiotics, such as cephalosporins, macrolides and fluoroquinolones. An inappropriate antimicrobial use for children against acute respiratory tract infection (ARTI) caused by the virus has been indicated. The aim of this study was to clarify the chronological prescription of oral antibiotics for ARTI in pediatric outpatients at acute diagnosis procedure combination (DPC) hospitals. We used MDV analyzer^® (medical data vision (MDV) Co., Ltd.) as a health insurance claims data analysis tool to investigate retrospectively. The investigation period was from January 1, 2013 to December 31, 2018. Subjects were outpatients aged 0 to 14 years who were recorded in clinical data as ARTI (ICD-10: J00, J01, J02, J20). Cochran-Armitage trend test was used for statistical analysis. The prescription rate of oral antibiotics and each category were evaluated. The prescription rate of antibiotics significantly decreased from 44.4％ to 31.7％ during 2013-2018. The prescription rate of each antibiotic significantly decreased from 20.1％ to 10.9％ for cephalosporins, from 20.8％ to 12.4％ for macrolides and from 2.6％ to 2.0％ for fluoroquinolones, respectively. Our results showed that the prescription rate of oral antibiotics decreased in pediatric outpatients with ARTI at acute DPC hospitals over time from 2013 to 2018 and each category was influenced by AMR action plan.