Abstract

Antimicrobial resistance is a major health concern. A primary cause is the inappropriate use of antimicrobials, particularly by patients with upper respiratory tract infection. However, baseline information for antibiotic use for common cold before being applied the National Action Plan on Antimicrobial Resistance in Japan is lacking. Here, we analyzed the inappropriate use of antibiotics in the working-age workers. We used large claims data from an annual health check-up for at least 5 consecutive years. Among 201,223 participants, we included 18,659 working-age workers who were diagnosed with common cold at a clinic/hospital. We calculated the proportion of patients with common cold who were prescribed antibiotics and analyzed predictive factors associated with antibiotics prescription. Antibiotics were prescribed to 49.2% (n = 9180) of patients diagnosed with common cold. In the logistic regression analysis, the group taking antibiotics was predominantly younger, male, without chronic diseases, and diagnosed at a small hospital/clinic (where the number of beds was 0–19). Cephems accounted for the highest proportion of prescribed antibiotics, with 40–45% of patients being prescribed antibiotics. Our data may be applied to prioritize resources such as medical staff-intervention or education of working-age people without chronic diseases who visit clinics for common cold to avoid the potential inappropriate use of antibiotics and prevent antimicrobial resistance acceleration.

Highlights

  • IntroductionA primary cause is the inappropriate use of antimicrobials, by patients with upper respiratory tract infection

  • Antimicrobial resistance is a major health concern

  • 49.2% of patients diagnosed with common cold were prescribed antibiotics (9180 [male/female: 7882/1298, 40.2 ± 9.9 years] vs. 9479 [male/female: 8015/1464, 42.6 ± 10.2 years]) (Table 1)

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Summary

Introduction

A primary cause is the inappropriate use of antimicrobials, by patients with upper respiratory tract infection. Baseline information for antibiotic use for common cold before being applied the National Action Plan on Antimicrobial Resistance in Japan is lacking. Our data may be applied to prioritize resources such as medical staff-intervention or education of working-age people without chronic diseases who visit clinics for common cold to avoid the potential inappropriate use of antibiotics and prevent antimicrobial resistance acceleration. Teratani et al retrospectively assessed antimicrobial drug selection and generation in acute respiratory tract infections (ARTIs) based on insurance claims data from 2013 to 2015 and reported that antibiotics are prescribed in more than 40% of outpatients diagnosed with ARTIs in J­apan[6]. By methicillin-resistant Staphylococcus aureus and fluoroquinolone-resistant Escherichia coli in Japan from 2011 to 2017, and death owing to BSI caused by those infections in 2017 was estimated at approximately 8000

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