173. Nationwide outpatient oral antimicrobial utilization by children in Japan
Session: Poster Abstract Session: Antimicrobial Stewardship: Interventions in Pediatric Populations
Thursday, October 4, 2018
Room: S Poster Hall
  • ☆☆Poster_IDweek2018_peds_all_PDF.pdf (3.3 MB)
  • Background: Antimicrobial resistance (AMR) is a major public health concern across the world. Japanese government set goals in national AMR action plan to reduce oral cephalosporins, macrolides and quinolones into a half of the 2013 use by 2020.We evaluated the nationwide antimicrobial use (AMU) of children in Japan using the dispensing receptive from the national administrative database in regard to the national AMR action plan.

    Methods: The national health claims database was interrogated for oral antibiotics dispensed from outpatient pharmacies in Japan to children under 15 years of age from January 2013 to December 2016. Information obtained from each prescription included age, residence area, days of therapy (DOT) for each antimicrobial from dispensing receptive. DOT was corrected by the resident population in area, and calculated as DOT/1000 pediatric inhabitants/day (DOT/PID). Chi-squared test for trend was performed to evaluate the annual changes of DOT/PID.

    Results: Total of 1,3869,332 oral antibiotic prescriptions were identified during 2013–2016. Total amount of antimicrobial used in children did not change (2013: 28.54 DOT/PID, 2016: 28.70 DOT/PID, Ptrend = 0.25).

    No statistically significant changes were observed in prescriptions of third generation cephalosporin (2013:10.21DOT/PID,2016:9.87DOT/PID, Ptrend=0.50), macrolide (2013:11.04 DOTID, 2016:10.72 DOT/PID, Ptrend=0.52), and quinolone (2013:1.46DOT/PID,2016:1.86DOT aged < 5 years compared to older infants, with the highest rate among children aged 1year. Targeted antimicrobials for AMR action plan showed similar distribution by age. (Figure 2).

    Conclusion: Interim assessment of the national AMR action plan revealed that the goals were not attainable without significant interventions in children by 2020.Overall antibiotic prescription as well as cephalosporins, macrolides and quinolones prescription were most prevalent in children aged 1 year. Antimicrobial stewardship targeting infants and younger children is necessary.

    Noriko Kinoshita, MD, Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan; Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan, Naho Morisaki, MD, MPH, PhD, Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan, Yusuke Okubo, MD, MPH, Department of Epidemiology, UCLA Fielding School of Public Health,, Los Angeles, CA, Kazuhiro Uda, MD, Division of Infectious Diseases, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan, Masashi Kasai, MD, Department of Infectious Disease Medicine, Hyogo Prefectural Kobe Children’s Hospital, Hyogo, Japan, Yuho Horikoshi, MD, Infectious Diseases, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan and Isao Miyairi, MD, St Jude Children's Research Hospital, Memphis, TN


    N. Kinoshita, None

    N. Morisaki, None

    Y. Okubo, None

    K. Uda, None

    M. Kasai, None

    Y. Horikoshi, None

    I. Miyairi, None

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