Significant reduction in antibiotic prescription rates in Japan following implementation of the national action plan on antimicrobial resistance (2016–20): a 9-year interrupted time-series analysis

• DOI: 10.1093/jacamr/dlaf062
• Publication Date: 2025-04-29T12:11:08Z
• Authors: Hideki Hashimoto; Naoki Kanda; Hiromasa Yoshimoto; Kazuo Goda; Naohiro Mitsutake; Shuji Hatakeyama
• Keywords: Interrupted time series; Action plan

Research on the effectiveness of Japan's national action plan antimicrobial resistance, including among individuals with HIV, remains scarce. To evaluate impact policies antibiotic prescription practices. Outpatient oral data from 2012 to 2020 were extracted a claims database comprising >98% Japanese population. Prescription rates stratified according class, diagnosis and HIV status. An interrupted time-series analysis was performed assess plan. average 129,989,400 prescriptions issued annually (1024 per 1000 population-years). Between 2020, rate decreased by 54%. The showed significant downward trend post-intervention (additional annual reduction in incidence ratio, 0.889; 95% confidence interval, 0.889-0.990). However, broad-spectrum antibiotics (third-generation cephalosporins, macrolides fluoroquinolones) remained prevalent, 84.7% 71.4% respectively. Antibiotic during outpatient visits for pharyngitis, sinusitis, bronchitis viral upper respiratory infections significantly (rate ratios = 0.66, 0.76, 0.51 0.49, respectively). ∼2.5-fold higher than those without. following implementation sharp decline likely due coronavirus disease pandemic, requires continued rebound monitoring. Reducing overuse critical focus.