ID | 63223 |
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Author |
Ishida, Tomoharu
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Hagiya, Hideharu
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Honda, Hiroyuki
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Nakano, Yasuhiro
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Ogawa, Hiroko
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Obika, Mikako
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Ueda, Keigo
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kataoka, Hitomi
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Hanayama, Yoshihisa
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Otsuka, Fumio
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Abstract | Antimicrobial stewardship for outpatients with acute respiratory tract infections (ARTIs) should be urgently promoted in this era of antimicrobial resistance. Previous large-sample studies were based on administrative data and had limited reliability. We aimed to identify current antimicrobial prescription practices for ARTIs by directly basing on medical records. This multicenter retrospective study was performed from January to December in 2018, at five medical institutes in Japan. We targeted outpatients aged >= 18 years whose medical records revealed International Classification of Diseases (ICD-10) codes suggesting ARTIs. We divided the eligible cases into three age groups (18-64 years, 65-74 years, and >= 75 years). We defined broad-spectrum antimicrobials as third-generation cephalosporins, macrolides, fluoroquinolones, and faropenem. Primary and secondary outcomes were defined as the proportion of antimicrobial prescriptions for the common cold and other respiratory tract infections, respectively. Totally, data of 3,940 patients were collected. Of 2,914 patients with the common cold, 369 (12.7%) were prescribed antimicrobials. Overall, compared to patients aged >= 75 years (8.5%), those aged 18-64 years (16.6%) and those aged 65-74 years (12.1%) were frequently prescribed antimicrobials for the common cold (odds ratio [95% confidential interval]; 2.15 [1.64-2.82] and 1.49 [1.06-2.09], respectively). However, when limited to cases with a valid diagnosis of the common cold by incorporating clinical data, no statistical difference was observed among the age groups. Broad-spectrum antimicrobials accounted for 90.2% of the antimicrobials used for the common cold. Of 1,026 patients with other respiratory infections, 1,018 (99.2%) were bronchitis, of which antimicrobials were prescribed in 49.9% of the cases. Broad-spectrum antimicrobials were the main agents prescribed, accounting for nearly 90% of prescriptions in all age groups. Our data suggested a favorable practice of antimicrobial prescription for outpatients with ARTIs in terms of prescribing proportions, or quantitative aspect. However, the prescriptions were biased towards broad-spectrum antimicrobials, highlighting the need for further antimicrobial stewardship in the outpatient setting from a qualitative perspective.
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Published Date | 2021-11-12
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Publication Title |
Plos One
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Volume | volume16
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Issue | issue11
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Publisher | Public Library Science
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Start Page | e0259633
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ISSN | 1932-6203
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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Copyright Holders | © 2021 Ishida et al.
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File Version | publisher
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DOI | |
Web of Science KeyUT | |
Related Url | isVersionOf https://doi.org/10.1371/journal.pone.0259633
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License | https://creativecommons.org/licenses/by/4.0/
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