Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Hatanodai 1-5-8, Shinagawa-ku, Tokyo, 142-8555, Japan.
Department of Medicinal Therapy Research, Pharmaceutical Education and Research Center, Meiji Pharmaceutical University, 2-522-1, Kiyose, Tokyo, Noshio, 204-8588, Japan.
Sci Rep. 2021 Nov 22;11(1):22701. doi: 10.1038/s41598-021-02204-3.
Antimicrobial resistance is a major health concern. A primary cause is the inappropriate use of antimicrobials, particularly by patients with upper respiratory tract infection. However, baseline information for antibiotic use for common cold before being applied the National Action Plan on Antimicrobial Resistance in Japan is lacking. Here, we analyzed the inappropriate use of antibiotics in the working-age workers. We used large claims data from an annual health check-up for at least 5 consecutive years. Among 201,223 participants, we included 18,659 working-age workers who were diagnosed with common cold at a clinic/hospital. We calculated the proportion of patients with common cold who were prescribed antibiotics and analyzed predictive factors associated with antibiotics prescription. Antibiotics were prescribed to 49.2% (n = 9180) of patients diagnosed with common cold. In the logistic regression analysis, the group taking antibiotics was predominantly younger, male, without chronic diseases, and diagnosed at a small hospital/clinic (where the number of beds was 0-19). Cephems accounted for the highest proportion of prescribed antibiotics, with 40-45% of patients being prescribed antibiotics. Our data may be applied to prioritize resources such as medical staff-intervention or education of working-age people without chronic diseases who visit clinics for common cold to avoid the potential inappropriate use of antibiotics and prevent antimicrobial resistance acceleration.
抗菌药物耐药性是一个主要的健康问题。主要原因之一是抗菌药物的不合理使用，特别是上呼吸道感染患者。然而，在日本实施《国家抗菌药物耐药行动计划》之前，针对普通感冒的抗生素使用基线信息尚缺乏。在这里，我们分析了工作年龄人群中抗生素的不合理使用情况。我们使用了来自至少连续 5 年年度健康检查的大型索赔数据。在 201223 名参与者中，我们纳入了 18659 名在诊所/医院诊断为普通感冒的工作年龄工人。我们计算了患有普通感冒并开具抗生素的患者比例，并分析了与抗生素处方相关的预测因素。在诊断为普通感冒的患者中，有 49.2%（n=9180）开具了抗生素。在逻辑回归分析中，使用抗生素的组主要是年龄较小、男性、没有慢性病，并且在小医院/诊所（床位 0-19 张）就诊。头孢菌素类药物占处方抗生素的比例最高，有 40-45%的患者开具了抗生素。我们的数据可用于优先考虑资源，例如对患有慢性病且因普通感冒就诊的工作年龄人群进行医务人员干预或教育，以避免潜在的抗生素不合理使用，并防止抗菌药物耐药性加速。
