Antibiotic prescriptions for Japanese outpatients with acute respiratory tract infections (2013–2015): A retrospective Observational Study

Toshihiro Koyama, Hideharu Hagiya, Yusuke Teratani, Yasuhisa Tatebe, Ayako Ohshima, Mayu Adachi, Tomoko Funahashi, Yoshito Zamami, Hiroyoshi Y. Tanaka, Ken Tasaka, Kazuaki Shinomiya, Yoshihisa Kitamura, Toshiaki Sendo, shiro Hinotsu, Mitsunobu R. Kano

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Objectives: Appropriate antibiotic prescriptions for outpatients with acute respiratory tract infections (ARTIs) are urgently needed in Japan. However, the empirical proof of this need is under-documented. Therefore, we aimed to determine antibiotic prescription rates, and the proportions of antibiotic classes prescribed for Japanese patients with ARTIs. Methods: We analysed health insurance claims data over 2013–2015 among Japanese patients aged <75 years and determined the following indicators: 1) visit rates for patients with ARTIs and antibiotic prescription rates per 1000 person-years, and 2) proportion of visits by antibiotic-prescribed patients with ARTIs. We defined broad-spectrum antibiotics using the WHO Anatomical Therapeutic Chemical classification 4 level codes. Results: Among 8.65 million visits due to ARTIs at 6859 hospitals and 62,024 physicians’ offices, the visit rate and antibiotic prescription rate per 1000 person-years were 990.6 (99% confidence interval [CI], 989.4–991.7) and 532.4 (99% CI, 531.6–533.3), respectively. The visit rates for patients aged 0–17, 18–59, and 60–74 years were 2410.0 (99% CI, 2407.2–2412.9), 683.6 (99% CI, 682.7–684.6), and 682.1 (99% CI, 678.2–686.0), and antibiotic prescription rates were 1093.3 (99% CI, 1091.4–1095.2), 434.1 (99% CI, 433.4–434.9), and 353.4 (99% CI, 350.7–356.1), respectively. The overall proportion of antibiotic prescriptions for ARTI visits was 52.7% and 91.3% of the antibiotics prescribed were broad-spectrum. Conclusions: Both the visit rates and antibiotic prescription rates for ARTIs were high in this Japanese cohort. The proportion of antibiotic prescriptions exceeded that recommended in the clinical guidelines. Thus, there might be a scope for reducing the current antibiotic prescription rate in Japan.

Original languageEnglish
Pages (from-to)660-666
Number of pages7
JournalJournal of Infection and Chemotherapy
Issue number7
Publication statusPublished - Jul 2020


  • Acute respiratory tract infection
  • Antibiotic prescription
  • Antimicrobial resistance
  • Antimicrobial stewardship
  • Health policy

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)


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