Factors associated with geographical variability of antimicrobial use in Japan

Kitano, Taito; Tsuzuki, Shinya; Koizumi, Ryuji; Aoyagi, Kensuke; Asai, Yusuke; Kusama, Yoshiki; Ohmagari, Norio

doi:10.1007/S40121-023-00893-Z

Title

Factors associated with geographical variability of antimicrobial use in Japan

Author

Kitano, Taito

Tsuzuki, Shinya

Koizumi, Ryuji

Aoyagi, Kensuke

Asai, Yusuke

Kusama, Yoshiki

Ohmagari, Norio

Abstract

Introduction: Evidence regarding the factors affecting the geographical variation of antimicrobial use (AMU) is relatively scarce. This study aimed to evaluate factors potentially associated with geographical variability of AMU per day per 1000 habitants in the 47 prefectures of Japan.Methods: This is an observational ecological study using the Japanese national database in 2019. The outcome was the defined daily doses per 1000 inhabitants per day by prefecture. Multivariable negative binomial regression analysis was conducted using patient- and physician-level variables.Results: The study included 605,391,054 defined daily doses of AMU in 2019 from the 47 prefectures. In the multivariable negative binomial regression analyses for the outcome of total AMU, the proportion of female individuals (adjusted rate ratio [aRR] 1.04 [1.01-1.08] per 1% increase, p = 0.021), the proportion of upper secondary graduates going to further education (aRR 1.01 [1.00-1.01] per 1% increase, p = 0.005), and the annual number of diagnoses related to upper respiratory infections (URIs) per 1000 inhabitants per day (aRR 1.21 [1.10-1.34], p < 0.001) were significantly correlated with total AMU.Conclusions: In this ecological study, the variability of total AMU by Japanese prefecture was associated with the proportion of female individuals, education level, and the number of URI diagnoses per population. The results suggest the potential need for additional stewardship efforts to reduce unnecessary antimicrobial prescriptions for URI.

Language

English

Source (journal)

Infectious Diseases and Therapy

Publication

London : Springer london ltd , 2023

ISSN

2193-8229

2193-6382

DOI

10.1007/S40121-023-00893-Z

Volume/pages