Cost of inappropriate antimicrobial use for upper respiratory infection in Japan

Tsuzuki, Shinya; Kimura, Yuki; Ishikane, Masahiro; Kusama, Yoshiki; Ohmagari, Norio

doi:10.1186/s12913-020-5021-1

Cited by 13 publications

(12 citation statements)

References 21 publications

(21 reference statements)

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“…The cohort included 2 804 245 eligible children (52% male; median [IQR] age,[8][9][10][11][12] years). Overall, 31% to 36% received inappropriate antibiotics for bacterial infections and 4% to 70% for viral infections.…”

Section: Resultsmentioning

confidence: 99%

Association of Inappropriate Outpatient Pediatric Antibiotic Prescriptions With Adverse Drug Events and Health Care Expenditures

et al. 2022

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IMPORTANCE Nonguideline antibiotic prescribing for the treatment of pediatric infections is common, but the consequences of inappropriate antibiotics are not well described. OBJECTIVETo evaluate the comparative safety and health care expenditures of inappropriate vs appropriate oral antibiotic prescriptions for common outpatient pediatric infections. DESIGN, SETTING, AND PARTICIPANTSThis cohort study included children aged 6 months to 17 years diagnosed with a bacterial infection (suppurative otitis media [OM], pharyngitis, sinusitis) or viral infection (influenza, viral upper respiratory infection [URI], bronchiolitis, bronchitis, nonsuppurative OM) as an outpatient from April 1, 2016, to September 30, 2018, in the IBM MarketScan Commercial Database. Data were analyzed from August to November 2021. EXPOSURES Inappropriate (ie, non-guideline-recommended) vs appropriate (ie, guideline-recommended) oral antibiotic agents dispensed from an outpatient pharmacy on the date of infection. MAIN OUTCOMES AND MEASURES Propensity score-weighted Cox proportional hazards modelswere used to estimate hazards ratios (HRs) and 95% CIs for the association between inappropriate antibiotic prescriptions and adverse drug events. Two-part models were used to calculate 30-day all-cause attributable health care expenditures by infection type. National-level annual attributable expenditures were calculated by scaling attributable expenditures in the study cohort to the national employer-sponsored insurance population. RESULTSThe cohort included 2 804 245 eligible children (52% male; median [IQR] age,[8][9][10][11][12] years). Overall, 31% to 36% received inappropriate antibiotics for bacterial infections and 4% to 70% for viral infections. Inappropriate antibiotics were associated with increased risk of several adverse drug events, including Clostridioides difficile infection and severe allergic reaction among children treated with a nonrecommended antibiotic agent for a bacterial infection (among patients with

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Section: Resultsmentioning

confidence: 99%

Association of Inappropriate Outpatient Pediatric Antibiotic Prescriptions With Adverse Drug Events and Health Care Expenditures

et al. 2022

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“…Therefore, prescribing trends may have changed since March 2016, when the official guidelines were issued. In fact, Tsuzuki et al reported that the annual additional cost of inappropriate antibiotic prescription for upper respiratory tract infections decreased from 2013 to 2016 17 . Career-pressure may higher in elderly working age population according to the social status; However, our data did not have the status for career.…”

Section: Discussionmentioning

confidence: 99%

Prescription pattern analysis for antibiotics in working-age workers diagnosed with common cold

Araki

Momo

Yasu

et al. 2021

Sci Rep

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Antimicrobial resistance is a major health concern. A primary cause is the inappropriate use of antimicrobials, particularly by patients with upper respiratory tract infection. However, baseline information for antibiotic use for common cold before being applied the National Action Plan on Antimicrobial Resistance in Japan is lacking. Here, we analyzed the inappropriate use of antibiotics in the working-age workers. We used large claims data from an annual health check-up for at least 5 consecutive years. Among 201,223 participants, we included 18,659 working-age workers who were diagnosed with common cold at a clinic/hospital. We calculated the proportion of patients with common cold who were prescribed antibiotics and analyzed predictive factors associated with antibiotics prescription. Antibiotics were prescribed to 49.2% (n = 9180) of patients diagnosed with common cold. In the logistic regression analysis, the group taking antibiotics was predominantly younger, male, without chronic diseases, and diagnosed at a small hospital/clinic (where the number of beds was 0–19). Cephems accounted for the highest proportion of prescribed antibiotics, with 40–45% of patients being prescribed antibiotics. Our data may be applied to prioritize resources such as medical staff-intervention or education of working-age people without chronic diseases who visit clinics for common cold to avoid the potential inappropriate use of antibiotics and prevent antimicrobial resistance acceleration.

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“…As a result, the sales of cephalosporins and the sum of all classes of antibiotics decreased gradually during the study period. Similarly, antibiotic use decreased during the same period [ 42 , 43 ]. The improved penicillin susceptibility rate of S .…”

Section: Discussionmentioning

confidence: 99%

Improved penicillin susceptibility of Streptococcus pneumoniae and increased penicillin consumption in Japan, 2013–18

et al. 2020

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Objectives To examine the association between penicillin susceptibility of Streptococcus pneumoniae and penicillin consumption in Japan. Methods We used Japan Nosocomial Infection Surveillance data on the susceptibility of S . pneumoniae and sales data obtained from IQVIA Services Japan K.K. for penicillin consumption. We analysed both sets of data by decomposing them into seasonality and chronological trend components. The cross-correlation function was checked using Spearman’s rank correlation coefficient to examine the correlation between susceptibility and consumption. Results After adjusting for seasonality, the susceptibility of S . pneumoniae to penicillins gradually improved (55.7% in 2013 and 60.6% in 2018, respectively) and penicillin consumption increased during the same period (0.76 defined daily doses per 1,000 inhabitants per day [DID] in 2013, and 0.89 DID in 2018). The results showed positive cross-correlation (coefficient 0.801, p -value < 0.001). In contrast, cephalosporin consumption decreased (3.91 DID in 2013 and 3.19 DID in 2018) and showed negative cross-correlation with susceptibility of S . pneumoniae to penicillins (coefficient −0.981, p -value < 0.001). Conclusions The rates of penicillin-susceptible S . pneumoniae isolates did not negatively correlate with penicillin consumption at the population level. Increased penicillin consumption might not impair the penicillin susceptibility of S . pneumoniae .

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Cost of inappropriate antimicrobial use for upper respiratory infection in Japan

Cited by 13 publications

References 21 publications

Association of Inappropriate Outpatient Pediatric Antibiotic Prescriptions With Adverse Drug Events and Health Care Expenditures

Association of Inappropriate Outpatient Pediatric Antibiotic Prescriptions With Adverse Drug Events and Health Care Expenditures

Prescription pattern analysis for antibiotics in working-age workers diagnosed with common cold

Improved penicillin susceptibility of Streptococcus pneumoniae and increased penicillin consumption in Japan, 2013–18

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