Prescription of antibiotics to pre-school children from 2005 to 2014 in Japan: a retrospective claims database study
Prescription of antibiotics to pre-school children from 2005 to 2014 in Japan: a retrospective claims database study
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DOI：
10.1093/pubmed/fdx045
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发表时间：
2018-06-01
影响因子：
4.4
通讯作者：
Kawakami, Koji
中科院分区：
文献类型：
--
作者：
Yoshida, Satomi;Takeuchi, Masato;Kawakami, Koji
背景抗生素是儿童最常用的处方药，但不适当的抗生素处方很普遍。我们的研究的目的是访问抗生素处方的全国性趋势，并确定不适当的处方上呼吸道感染（URI）在学龄前儿童在Japanes.Methods从行政索赔数据库的数据，从2005年1月至2014年9月在日本进行了检查。我们确定了门诊抗生素处方索赔，并描述了从出生到6岁随访的受试者的处方模式。结果在155556名儿童中，男性占51.6%，女性占48.4%。66.4%的患者使用抗生素，其中第三代头孢菌素使用最多（38.3%），其次是大环内酯类（25.8%）和青霉素（16.0%）。非细菌性URI的抗生素处方与男性（OR = 1.06，CI：1.05-1.07）、机构规模、非儿科（OR = 2.11，CI：2.08-2.14）和非工作时间就诊（OR = 1.64，CI：1.61-1.68）相关。此外，非细菌性URI的不适当处方与年龄、性别、设施特征、非儿科和非小时访视的增加相关。
Background Antibiotics are the most frequently prescribed medications for children but inappropriate antibiotic prescribing is prevalent. The purpose of our study was to access the nationwide trend in antibiotic prescriptions, and to ascertain inappropriate prescribing for upper respiratory infections (URIs) in pre-school children in Japan.Methods Data from the administrative claims database from 2005 January to 2014 September in Japan were examined. We identified outpatient antibiotic prescription claims and described prescription patterns of subjects who were followed from birth to 6 years of age. Logistic regression analyses were performed to estimate odd ratios (ORs) and their 95% confidence intervals (CIs) for factors associated with inappropriate antibiotic prescriptions.Results Of 155 556 children in the database, 51.6% were male and 48.4% were female. Antibiotics were prescribed for 66.4% of the cohort, with third generation cephalosporin the most prescribed (38.3%), followed by macrolides (25.8%), and penicillin (16.0%). Antibiotic prescriptions for non-bacterial URIs were associated with male gender (OR = 1.06, CI: 1.05-1.07), facility scale, non-pediatrics (OR = 2.11, CI: 2.08-2.14) and out-of-hour visit (OR = 1.64, CI: 1.61-1.68).Conclusions Third generation cephalosporins and macrolides are widely prescribed to Japanese pre-school children. Furthermore, inappropriate prescriptions for non-bacterial URIs are associated with increasing age, gender, facility characteristics, non-pediatrics and out-of-hour visits.