Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto, Japan.
J Public Health (Oxf). 2018 Jun 1;40(2):397-403. doi: 10.1093/pubmed/fdx045.
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.
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.
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).
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.
抗生素是儿童最常开的药物，但抗生素的使用并不恰当。我们研究的目的是评估日本全国范围内抗生素处方的趋势，并确定日本学龄前儿童上呼吸道感染（URIs）中不适当的处方情况。
检查了日本从 2005 年 1 月至 2014 年 9 月的行政索赔数据库中的数据。我们确定了门诊抗生素处方，并描述了从出生到 6 岁的患者的处方模式。使用逻辑回归分析来估计与不适当的抗生素处方相关的因素的比值比（OR）及其 95％置信区间（CI）。
在数据库中的 155556 名儿童中，男性占 51.6％，女性占 48.4％。该队列中有 66.4％的儿童开了抗生素，第三代头孢菌素的处方最多（38.3％），其次是大环内酯类（25.8％）和青霉素（16.0％）。非细菌性 URIs 的抗生素处方与男性（OR = 1.06，CI：1.05-1.07），医疗机构规模，非儿科（OR = 2.11，CI：2.08-2.14）和就诊时间有关（OR = 1.64，CI：1.61-1.68）。
第三代头孢菌素和大环内酯类广泛用于日本学龄前儿童。此外，非细菌性 URIs 的不适当处方与年龄，性别，医疗机构特征，非儿科和就诊时间增加有关。
