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Recent patterns in antibiotic use for children with group A streptococcal infections in Japan
Yusuke Okubo1, Nobuaki Michihata2, Naho Morisaki3
1Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Insights
Third-generation cephalosporins are frequently overprescribed for pediatric group A streptococcal infections in Japan. This study highlights the need for improved antibiotic stewardship and physician education to ensure appropriate penicillin use.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial stewardship
- Health services research
Background:
- Antibiotics are commonly prescribed for children, but inappropriate use is a significant issue.
- Group A streptococcal infections in children warrant careful antibiotic selection.
Purpose of the Study:
- To analyze trends in antibiotic prescribing for pediatric group A streptococcal infections in Japan.
- To identify factors associated with appropriate antibiotic selection, particularly penicillin use.
Main Methods:
- Retrospective analysis of outpatient data from the Japan Medical Data Center database.
- Inclusion of patients under 18 years diagnosed with group A streptococcal infection.
- Multivariable log-binomial regression to evaluate factors associated with penicillin prescriptions.
Main Results:
- 5030 pediatric patients with group A streptococcal infection were identified.
- Third-generation cephalosporins were prescribed in 53.3% of cases, while penicillins were used in 40.1%.
- Out-of-hours visits correlated with penicillin prescriptions (PR=1.10), whereas non-pediatric/internal medicine departments were linked to non-penicillin use (PR=0.57).
Conclusions:
- Third-generation cephalosporins are overused in pediatric group A streptococcal infections.
- Findings underscore the need for physician education and health policies to promote appropriate antibiotic prescribing.
- Optimizing antibiotic selection can improve treatment outcomes and combat antimicrobial resistance.
Objectives:
Antibiotics are the most frequently prescribed medicines for children, however inappropriate antibiotic prescribing is prevalent. This study investigated recent trends in antibiotic use and factors associated with appropriate antibiotic selection among children with group A streptococcal infections in Japan.
Methods:
Records of outpatients aged <18years with a diagnosis of group A streptococcal infection were obtained using the Japan Medical Data Center database. Prescription patterns for antibiotics were investigated and factors associated with penicillin use were evaluated using a multivariable log-binomial regression model.
Results:
Overall, 5030 patients with a diagnosis of group A streptococcal infection were identified. The most commonly prescribed antibiotics were third-generation cephalosporins (53.3%), followed by penicillins (40.1%). In the multivariable log-binomial regression analysis, out-of-hours visits were independently associated with penicillin prescriptions [prevalence ratio (PR)=1.10, 95% confidence interval (CI) 1.03-1.18], whereas clinical departments other than paediatrics and internal medicine were related to non-penicillin prescriptions (PR=0.57, 95% CI 0.46-0.71).
Conclusions:
Third-generation cephalosporins were overprescribed for children with group A streptococcal infections. This investigation provides important information for promoting education for physicians and for constructing health policies for appropriate antibiotic prescription.
