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Recent Prescription Patterns for Children With Acute Infectious Diarrhea

Okubo, Yusuke*,†,‡; Miyairi, Isao§,||; Michihata, Nobuaki; Morisaki, Naho; Kinoshita, Noriko§; Urayama, Kevin Y.†,#; Yasunaga, Hideo

Journal of Pediatric Gastroenterology and Nutrition: January 2019 - Volume 68 - Issue 1 - p 13–16
doi: 10.1097/MPG.0000000000002115
Short Communications: Gastroenterology
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Background: This study investigated recent trends in antibiotic use and factors associated with antibiotic use among children with acute infectious diarrhea. We obtained records of outpatients aged under 18 years diagnosed with acute infectious diarrhea from the Japan Medical Data Center database during 2012–2015.

Objective: We investigated prescription patterns of antibiotics at their initial visit and evaluated factors associated with antibiotic usage using multivariable log-binomial regression models.

Results: Overall, we identified 4493 patients diagnosed with acute infectious diarrhea; 29.6% received antibiotics. The most commonly prescribed antibiotic is fosfomycin (20.3%). In multivariable log-binomial regression analysis, out-of-hour visits, clinical diagnoses of suspected bacterial enterocolitis, private outpatient clinics, and pediatric departments are significantly associated with higher prevalence of antibiotic use.

Conclusions: Antibiotics are over-prescribed for children with acute infectious diarrhea. Our investigation provides important information to promote education of physicians and of health policy considerations for appropriate antibiotic prescription practices.

*Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA

Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan

Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan

§Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan

||Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, Memphis, TN

Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

#Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.

Address correspondence and reprint requests to Yusuke Okubo, MD, MPH, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 1570074, Japan (e-mail: sunning_dale@yahoo.co.jp).

Received 11 April, 2018

Accepted 12 July, 2018

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org).

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan; Ministry of Education, Culture, Sports, Science and technology, Japan; and the Japan Agency for Medical Research and Development.

The authors have no financial relationships and conflicts of interest relevant to this article to disclose.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,