Recent Prescription Patterns for Children with Acute Infectious Diarrhea

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. Conclusion: 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. Address correspondence and reprint requests to Yusuke Okubo, 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 Financial Disclosure: The authors have no financial relationships relevant to this article to disclose. Funding source: 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. Potential Conflict of Interest: The authors have no conflict of interest relevant to this article to disclose. Authorship statement Drs. Okubo and Michihata designed the data collection instruments, coordinated data, drafted the initial manuscript, performed the initial analyses. Drs. Kinoshita, Morisaki, Miyairi, Urayama, and Prof. Yasunaga supervised data collection, revised the manuscript, and approved the final manuscript as submitted. Each author listed on the manuscript has seen and approved the submission of this version of the manuscript and takes full responsibility for its contents. Supplemental Table 1, Supplemental Digital Content, https://ift.tt/2ODE5x5 Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.jpgn.org). © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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