Antibiotics for hospitalized children with community-acquired pneumonia in Japan: Analysis based on Japanese national database.

Abstract

INTRODUCTION:

Community-acquired pneumonia (CAP) is one of the most common causes of pediatric infection requiring hospitalization. Antimicrobial resistance due to the inappropriate use poses a threat worldwide. Our objective is to analyze and optimize the trends of antibiotics used for pediatric inpatients with CAP in a claims database provided by the Ministry of Health, Labour and Welfare.

METHODS:

Our database randomly sampled 10% of the hospitalized patients every October from 2011 to 2014. Patients aged <15 years in whom antibiotic therapy was initiated within two days of admission were listed. Subsequently, we investigated the antibiotics administered on the first day of prescription.

RESULTS:

A total of 4,831 antibiotics were prescribed for 3,909 patients. Many patients aged ≤ five years were treated with β-lactams alone whereas many patients aged ≥ six years were treated with a single antibiotic, such as a macrolide, tetracycline, and quinolone, which covers atypical bacteria. Combination therapy was primarily used in children aged ≥ six years (nearly 30%); the main combination was a β-lactam and non-β-lactam covering atypical bacteria. Ampicillin-sulbactam was the most frequently prescribed β-lactam in children of all ages other than infants. Ampicillin, however, was most often prescribed in infants, but its usage rate was low at other ages.

CONCLUSIONS:

Antibiotics were appropriately prescribed and were similar to that recommended in the 2011 guidelines for pediatric inpatients with CAP. However, combination therapy was frequently prescribed in children aged ≥ six years. According to the revised guidelines in 2017, ampicillin should be used more frequently for patients hospitalized with CAP.

• Authors: Misuzu Yahaba, Kazutaka Yamagishi, Shingo Yamazaki, Shin Takayanagi, Yohei Kawasaki, Toshibumi Taniguchi, Naruhiko Ishiwada, Hidetoshi Igari
• Journal: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (J Infect Chemother) Vol. 27 Issue 3 Pg. 461-465 (Mar 2021) ISSN: 1437-7780 [Electronic] Netherlands
• PMID: 33176994 (Publication Type: Journal Article)
• Copyright: Copyright © 2020. Published by Elsevier Ltd.

Chemical References

• Anti-Bacterial Agents

Topics

• Anti-Bacterial Agents (therapeutic use)
• Child
• Child, Hospitalized
• Community-Acquired Infections (drug therapy, epidemiology)
• Humans
• Infant
• Japan (epidemiology)
• Pneumonia (drug therapy, epidemiology)
• Pneumonia, Bacterial (drug therapy)