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J Glob Antimicrob Resist. 2018 Jun;13:55-59. doi: 10.1016/j.jgar.2017.11.004. Epub 2017 Nov 13.

Recent patterns in antibiotic use for children with group A streptococcal infections in Japan.

Author information

1
Department 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. Electronic address: sunning_dale@yahoo.co.jp.
2
Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
3
Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan.
4
Office for Infectious Control, National Center for Child Health and Development, Tokyo, Japan.
5
Graduate School of Public Health, St Luke's International University, Tokyo, Japan.
6
Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.

Abstract

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.

KEYWORDS:

Antibiotics; Children; Group A streptococcus; Infection

PMID:
29146149
DOI:
10.1016/j.jgar.2017.11.004
[Indexed for MEDLINE]

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