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Published on: March 16, 2018
Improvement in the appropriate antimicrobial usage for treating pediatric acute otitis media in Japan: A descriptive
Masamitsu Kono1, Gen Sugita1, Koju Itahashi2
1Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama, Wakayama, 641-8510, Japan.
Insights
Antimicrobial prescriptions for pediatric acute otitis media (AOM) significantly decreased from 91% to 40% between 2001 and 2019. This shift reflects improved antimicrobial stewardship and guideline adherence in children.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial stewardship
- Clinical practice guidelines
Background:
- Acute otitis media (AOM) is a common childhood infection.
- Antimicrobial overprescription has been a concern in pediatric AOM treatment.
Purpose of the Study:
- To investigate trends in antimicrobial prescribing for pediatric AOM.
- To assess the impact of educational efforts on antimicrobial use for AOM.
Main Methods:
- Descriptive study utilizing an electronic medical record database.
- Analysis of 10,797 pediatric patients with AOM (2001-2019).
- Inclusion of 4786 patients with AOM and no comorbidities.
Main Results:
- Antimicrobial prescription rates for pediatric AOM declined from 91% (2001) to 40% (2019).
- Penicillin use increased, while cephalosporin use decreased significantly.
- Acetaminophen prescription rose from 33% to 58%.
Conclusions:
- Educational initiatives and clinical guidelines have improved antimicrobial prescribing for pediatric AOM.
- A trend towards more appropriate antimicrobial use was observed.
- No increase in adverse reactions was noted with changing antimicrobial patterns.
Objectives:
We investigated changes in prescriptions for antimicrobial agents to treat children with acute otitis media (AOM).
Methods:
A descriptive study using an electronic medical record database. Of 199,896 patients enrolled between 2001 and 2019, a total of 10,797 were aged <16 years and had AOM as their first and primary disease (overall pediatric AOM cohort). In addition, 4786 patients with AOM without other comorbidities (pediatric AOM cohort) were included.
Results:
In the overall pediatric AOM cohort, the age distribution ranged from 11% to 23% for those younger than 2 years and from 66% to 77% for those younger than 6 years, with no change over time. In the pediatric AOM cohort, the antimicrobial prescription rate was 91% in 2001 but declined to 40% by 2019. Antimicrobial use increased from 0% to 75% for penicillins, whereas use of cephalosporins decreased from 84% to 10%. The prescription rate for acetaminophen alone increased from 33% to 58%. There were no differences in the incidence of adverse reactions among the prescribed antimicrobials.
Conclusions:
Due to education efforts and promotion of the proper use of antimicrobials through means such as the Clinical practice guidelines for the diagnosis and management of acute otitis media in children (2006) and the Manual of Antimicrobial Stewardship (2016), a change in the use of antimicrobials occurred, leading to a trend to more proper use of these agents.
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