2021. Comparison of Patterns of National Oral Antibiotic Use Between All Dentists and Medical Doctors in Japan in 2016 Using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB)

Abstract

BackgroundAntimicrobial resistance (AMR) is a global threat for both dentists and medical doctors. The Japanese national action plan on AMR targets a 50% reduction in the use of oral broad-spectrum antimicrobials by 2020 compared with its use in 2013. However, no study has compared the pattern of oral antimicrobial use (AMU) in outpatient settings between all dentists and medical doctors in Japan using the national database of health insurance claims and specific health checkups (NDB).MethodsData of oral AMU in outpatient settings prescribed by both all dentists (n = 104,533) and medical doctors (n = 319,480) in Japan in 2016 were evaluated using NDB collected by the Ministry of Health, Labor and Welfare of Japan; the data accounted for 98% of the total claim data in Japan. Antimicrobials were classified by the World Health Organization (WHO) defined Anatomical Therapeutic Chemicals Classification. WHO measures the number of AMU using defined daily dose per 1,000 inhabitant-days (DIDs).The pattern of oral AMU between all dentists and medical doctors in Japan in 2016 was compared.ResultsThe values of oral AMU in outpatient settings among all dentists (n = 104,533) and medical doctors (n = 319,480) in Japan were 1.20 and 12.11, respectively. The proportions of AMU among dentists were cephalosporins, 65.1%; macrolides, 18.9%; quinolones, 5.5%; and penicillin, 8.7%. In contrast, the proportions of AMU among medical doctors were cephalosporins, 23.1%; macrolides, 36.9%; quinolones, 22.2%; and penicillin, 8.1%. There were differences in the pattern of oral AMU between dentists and medical doctors (P < 0.001) (Table 1).ConclusionAlthough the value of total oral AMU among dentists was 9.9% of medical doctors, the proportion of cephalosporin use, which was thought to be inappropriate prescribing, was higher among dentists than among medical doctors. Further studies that are adjusted to patients’ characteristics are needed. Disclosures All authors: No reported disclosures.