ArticleCureus2025
Effect of Educational Activities on Pediatricians Prescribing Oral Antibiotics in Pediatric Emergency Rooms.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundAnalyses of global antibiotic prescribing trends have identified Japan as one of the countries with the highest rates of antibiotic overprescription in pediatric outpatient care, thus indicating the necessity of antimicrobial stewardship for pediatricians.
methodsWe conducted two educational workshops for pediatricians in October 2018 and October 2019 in Yamanashi Prefecture, Japan, and then surveyed their effect on preferences for antibiotic prescription rates using questionnaires. Antibiotic prescribing in two pediatric emergency rooms for three years was also evaluated through health insurance claims. The primary objective is to evaluate changes in prescribing preferences, and the secondary objective is to assess changes in monthly prescribing rates and antibiotic class-specific prescribing rates.
resultsImmediately before the first workshop, 39.4% (28/71) of respondents agreed with prescribing antibiotics for a hypothetical case of mild acute otitis media. This percentage decreased to 16.4% (9/55) in the post-workshop survey. However, one year later, just before the second workshop, 44.0% (22/50) of respondents agreed with prescribing antibiotics. The oral antibiotic prescribing rate in pediatric emergency rooms decreased from 18.3% (4836/26,484 patient visits) in the baseline year (2017) to 12.4% (2868/23,188) and 12.2% (2651/21,709) in 2018 and 2019, respectively. The prescribing rate of cephems among all prescribed antibiotics decreased from 53.8% to 46.4% and 43.4%, while that of semisynthetic penicillin increased from 26.7% to 34.7% and 35.1%, respectively. A transient reduction in seasonal prescribing rate was observed in the autumn of 2018 and 2019, aligning with the timing of the workshops.
conclusionsAntibiotic prescribing preferences and behavior among pediatricians changed following the workshops. However, the impact of these workshops gradually diminished over time, underscoring the importance of sustained antimicrobial stewardship interventions.
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