Prescription of antibiotics to pre-school children from 2005 to 2014 in Japan: a retrospective claims database study.

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.