Observational studyBMC health services research2020
Cost of inappropriate antimicrobial use for upper respiratory infection in Japan.
Observational study in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Vaccines for the common cold.The Cochrane database of systematic reviews · 2022Pooled it
- Antimicrobial use for influenza-like illnesses in Nha Trang, Vietnam: a cross-sectional study.BMJ open · 2025Observational
- Association of patient, physician and visit characteristics with inappropriate antibiotic prescribing in Japanese primary care: a cross-sectional study.BMJ public health · 2025Article
- Development of a clinical scoring system to make a presumptive diagnosis of Kyasanur Forest Disease: a case-control study from South India.Le infezioni in medicina · 2024Article
- Comparative Safety and Attributable Healthcare Expenditures Following Inappropriate Versus Appropriate Outpatient Antibiotic Prescriptions Among Adults With Upper Respiratory Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Investigation of oral macrolide prescriptions in Japan using a retrospective claims database, 2013-2018.PloS one · 2023Review
- Last Resort Antibiotics Costs and Reimbursement Analysis of Real-Life ICU Patients with Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Germany.Healthcare (Basel, Switzerland) · 2022Article
- Association of Inappropriate Outpatient Pediatric Antibiotic Prescriptions With Adverse Drug Events and Health Care Expenditures.JAMA network open · 2022Article
- Exploring the economic impact of inappropriate antibiotic use: the case of upper respiratory tract infections in Ghana.Antimicrobial resistance and infection control · 2022Article
- Insertion of a Clinical Pathway Pop-Up Window into a Computer-Based Prescription System: A Method to Promote Antibiotic Stewardship in Upper Respiratory Tract Infection.Antibiotics (Basel, Switzerland) · 2021Article
- Prescription pattern analysis for antibiotics in working-age workers diagnosed with common cold.Scientific reports · 2021Article
- Improved penicillin susceptibility of Streptococcus pneumoniae and increased penicillin consumption in Japan, 2013-18.PloS one · 2020Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundAntibiotics are often prescribed inappropriately to patients with upper respiratory infection (URI) in ambulatory care settings; however, the economic burden of such prescription has not been quantitatively assessed. Here, we aimed to evaluate the additional cost of antimicrobial prescription for URI at the population level in Japan.
methodsWe conducted a retrospective observational survey using longitudinal claims data between 2013 and 2016 obtained from JMDC Claims Database, which contains data from 5·1 million corporate employees and family members under the age of 65 years. Appropriateness of antibiotic prescription was assessed by a panel of six infectious disease physicians according to ICD-10 code in JMDC Claims Database. Total additional cost of antibiotic prescription for URI at the national level was estimated by weighting of age-structured population data.
resultsThe annual additional cost of inappropriate antibiotic prescription for URI was estimated at 423·6 (95% CI: 416·8-430·5) million USD in 2013, 340·9 (95% CI: 335·7-346·2) million USD in 2014, 349·9 (95% CI: 344·5-355·3) million USD in 2015, and 297·1 (95% CI: 292·4-301·9) million USD in 2016. Three classes of broad-spectrum oral antibiotics (third-generation cephalosporins, macrolides, and fluoroquinolones) accounted for > 90% of the total additional cost.
conclusionsAlthough a decreasing trend was observed, annual additional costs of inappropriate antibiotic prescriptions for URI could be a substantial economic burden in Japan. Appropriately prescribing broad-spectrum oral antibiotics might be an important issue to reduce unnecessary medical costs in Japanese ambulatory care.
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