Appropriate Use of Antibiotics for Acute Respiratory Tract Infections in a Community Hospital in Rural Japan: A Medical Record-Based Study.

Background: Inappropriate antibiotic prescribing remains a global concern, as it contributes to adverse drug reactions, increased healthcare costs, and the spread of antimicrobial resistance. In Japan, several studies have investigated antibiotic prescription patterns; however, most rely solely on insurance claims data, which may not accurately reflect clinical diagnoses. This study aimed to evaluate the appropriateness of antibiotic use for acute respiratory tract infections (ARTIs) by cross-referencing disease names recorded in insurance claims with diagnoses documented in electronic medical records. Methods: We conducted a retrospective review of outpatient records from Hino Hospital, a community-based general hospital providing primary care services, between April 1, 2017, and March 31, 2018. Patients diagnosed with ARTIs were identified through claims data, and their diagnoses were confirmed using their medical records. The appropriateness of antibiotic prescriptions was assessed based on the Japanese clinical guideline, Results: A total of 485 patients were included. The overall antibiotic prescription rate for ARTIs was 17.1%, and among those prescribed antibiotics, only 14.5% were deemed appropriate. The general medicine department had the lowest prescription rate and the highest rate of appropriate use among all departments. Conclusion: This study provides a chart-based analysis of inappropriate antibiotic use for ARTIs in Japan. To reduce inappropriate antibiotic prescriptions, multifaceted interventions and continuous evaluation will be necessary.