Recent Prescription Patterns for Children With Acute Infectious Diarrhea

Okubo, Yusuke; Miyairi, Isao; Michihata, Nobuaki; Morisaki, Naho; Iwamoto, Noriko; Urayama, Kevin Y.; Yasunaga, Hideo

doi:10.1097/mpg.0000000000002115

Cited by 29 publications

(25 citation statements)

References 16 publications

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“…However, the appropriateness of the use could not be estimated, as the details of antibiotic prescription patterns were limited. Only a few studies have described antibiotic prescription patterns in Japan, and they are restricted to acute respiratory infections and gastroenteritis (Okubo et al, 2019;Yoshida et al, 2018). In addition, antibiotic prescription rates per population, frequently used as a measurement of antibiotic use in many countries (Dolk et al, 2018;King et al, 2019), have heretofore been unavailable in Japan.…”

Section: Introductionmentioning

confidence: 99%

Indications and classes of outpatient antibiotic prescriptions in Japan: A descriptive study using the national database of electronic health insurance claims, 2012–2015

Hashimoto

Saito

Sato

et al. 2020

International Journal of Infectious Diseases

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To evaluate condition-specific antibiotic prescription rates and the appropriateness of antibiotic use in outpatient settings in Japan. Methods: Using Japan's national administrative claims database, all outpatient visits with infectious disease diagnoses were linked to reimbursed oral antibiotic prescriptions. Prescription rates stratified by age, sex, prefecture, and antibiotic category were determined for each infectious disease diagnosis. The proportions of any antibiotic prescription to all infectious disease visits and the proportions of first-line antibiotic prescriptions to all antibiotic prescriptions were calculated for each infectious disease diagnosis. Results: Of the 659 million infectious disease visits between April 2012 and March 2015, antibiotics were prescribed in 266 million visits (704 prescriptions per 1000 population per year). Third-generation cephalosporins, macrolides, and quinolones accounted for 85.9% of all antibiotic prescriptions. Fifty-six percent of antibiotic prescriptions were directed toward infections for which antibiotics are generally not indicated. The diagnoses with frequent antibiotic prescription were bronchitis (184 prescriptions per 1000 population per year), viral upper respiratory infections (166), pharyngitis (104), sinusitis (52), and gastrointestinal infection (41), for which 58.3%, 40.6%, 58.9%, 53.9%, and 26.1% of visits antibiotics were prescribed, respectively. First-line antibiotics were rarely prescribed for pharyngitis (8.8%) and sinusitis (9.8%). More antibiotics were prescribed for children aged 0-9 years, adult women, and patients living in western Japan. Conclusions: Antibiotic prescription rates are high in Japan. Acute respiratory or gastrointestinal infections, which received the majority of the antibiotics generally not indicated, should be the main targets of antimicrobial stewardship intervention.

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Section: Introductionmentioning

confidence: 99%

Indications and classes of outpatient antibiotic prescriptions in Japan: A descriptive study using the national database of electronic health insurance claims, 2012–2015

Hashimoto

Saito

Sato

et al. 2020

International Journal of Infectious Diseases

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“…Due to the presence of compelling evidences showing an effect in reducing the duration of diarrhoea of about 24 h and the risk of severe AID, several guidelines recommend the use of probiotics worldwide, and a large number of children currently receives probiotics for the treatment of AID [ 57 ]. A recent study in about 4500 Japanese children reported 46.7% of probiotic prescription during an AID episode [ 58 ]. The ESPGHAN is currently updating the official recommendations for the use of selected probiotic strains in children with AID [ 54 , 59 ].…”

Section: Resultsmentioning

confidence: 99%

Probiotics’ efficacy in paediatric diseases: which is the evidence? A critical review on behalf of the Italian Society of Pediatrics

et al. 2020

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During the last decade several paediatric studies have been published with different possible indications for probiotics, leading to a global increase of probiotics’ market. Nevertheless, different study designs, multiple single/combined strains and small sample size still leave many uncertainties regarding their efficacy. In addition, different regulatory and quality control issues make still very difficult the interpretation of the clinical data. The objective of this review is to critically summarise the current evidence on probiotics’ efficacy and safety on a different number of pathologies, including necrotizing enterocolitis, acute infectious diarrhoea, allergic diseases and functional gastrointestinal disorders in order to guide paediatric healthcare professionals on using evidence-based probiotics’ strains. To identify relevant data, literature searches were performed including Medline-PubMed, the Cochrane Library and EMBASE databases. Considering probiotics strain-specific effects, the main focus was on individual probiotic strains and not on probiotics in general.

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“…35 These findings were consistent with those of our previous studies with respect to overuse and physician preference of broad-spectrum antibiotics in common pediatric infectious diseases. [36][37][38][39] The discontinuation of ineffective, inappropriate, or potentially harmful treatment may be necessary for sustainable medicine. A previous study in the United States based on a large database reported that 60% of adults hospitalized with asthma received antibiotics in the absence of an indication for antibiotics with a wide variation in antibiotic treatment patterns in adults.…”

Section: Discussionmentioning

confidence: 99%

Association between early antibiotic treatment and clinical outcomes in children hospitalized for asthma exacerbation

Okubo

Horimukai

Michihata

et al. 2021

Journal of Allergy and Clinical Immunology

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Recent Prescription Patterns for Children With Acute Infectious Diarrhea

Abstract: Antibiotics are over-prescribed for children with acute infectious diarrhea. Our investigation provides important information to promote education of physicians and of health policy considerations for appropriate antibiotic prescription practices.

Cited by 29 publications

References 16 publications

Indications and classes of outpatient antibiotic prescriptions in Japan: A descriptive study using the national database of electronic health insurance claims, 2012–2015

Indications and classes of outpatient antibiotic prescriptions in Japan: A descriptive study using the national database of electronic health insurance claims, 2012–2015

Probiotics’ efficacy in paediatric diseases: which is the evidence? A critical review on behalf of the Italian Society of Pediatrics

Association between early antibiotic treatment and clinical outcomes in children hospitalized for asthma exacerbation

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