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Change in clinical practice variations for antibiotic prescriptions across different pediatric clinics: A Japan's

Yusuke Okubo1, Hiroki Nariai2, Karin B Michels3

  • 1Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, (UCLA), Los Angeles, CA, USA.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|August 11, 2021
PubMed

Insights

Japan's National Action Plan reduced antibiotic prescriptions, but significant variations persist among pediatric clinics. One-fourth of clinics showed no improvement, highlighting the need for targeted interventions to optimize antimicrobial stewardship.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Japan implemented a National Action Plan in 2016 to curb antibiotic prescriptions.
  • Understanding trends and variations in antibiotic prescribing patterns is crucial for effective antimicrobial resistance strategies.
  • Previous data on national-level prescription trends in routine pediatric care settings remain limited.

Purpose of the Study:

  • To analyze antibiotic prescription rates and patterns in Japanese pediatric clinics from fiscal year 2013-2018.
  • To evaluate the impact of the National Action Plan on antibiotic prescribing.
  • To identify variations in prescription trends across different clinics.

Main Methods:

  • Retrospective cohort study utilizing a national database in Japan.
  • Included clinics with >100 pediatric infectious disease outpatients monthly (FY 2013-2018).
  • Analyzed antibiotic prescription rates, patterns (WHO AWaRe groups, Amoxicillin Index), and variations.

Main Results:

  • 2278 clinics and 94,414,170 visits were analyzed.
  • Most clinics predominantly used 'Watch' group antibiotics (median 85.4%) over 'Access' (median 13.8%).
  • The Action Plan correlated with reduced prescription rates, but impact varied significantly; 7.3% of clinics increased rates.

Conclusions:

  • The National Action Plan demonstrated impact on reducing antibiotic prescriptions, but with considerable heterogeneity.
  • Significant variations in antibiotic prescribing patterns exist across pediatric clinics.
  • A substantial proportion of clinics (one-fourth) did not improve prescribing patterns post-Action Plan implementation.
Abstract

Keywords:
AntibioticsJapanNational action plan on antimicrobial resistanceNational databasePediatrics

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