60% of antibiotics were prescribed to colds etc. ineffectively - Jichi Medical University Survey

Recently Asahi Shimbun Digital reported the following:

抗生物質の６割、効果ない風邪などに処方 自治医大調査

 朝日新聞社 2020/01/03 20:49

　国内の外来診療で出された抗菌薬（抗生物質）の６割近くが、効果がない風邪などウイルス性の感染症への不必要な処方だったことが、自治医科大などの研究チームの調査でわかった。７５％は専門医らが推奨していない薬だった。抗菌薬の不適切な使い方は薬剤耐性菌が生じる原因になるため、研究チームは適正な使い方を呼びかけている。

　チームは全国の診療、処方明細書（レセプト）などのデータをもとに２０１２～１４年度に外来診療で処方された抗菌薬と対象の病気などを調査。年平均約８９５７万件処方されていた。人口１千人あたり７０４件処方されており、米国の１・４倍だった。

　抗菌薬が必要とされる疾患に処方されたのは全体の８％にとどまった。処方された５６％は風邪や急性気管支炎など通常はウイルスが原因の病気だった。抗菌薬は細菌感染の治療薬でウイルス性の感染症には効果がない。また急性咽頭（いんとう）炎（扁桃（へんとう）炎）や急性副鼻腔（ふくびくう）炎などへの処方が３６％あったが、細菌が原因のケースは１～２割のため、効果がないウイルス性にも多く処方されていたとみられる。

　処方された抗菌薬の８６％は様々な種類の細菌に効く「広域抗菌薬」と呼ばれるタイプ。耐性菌が発生、増殖しやすいため、欧州ではまれにしか使われない。専門医らによる指針で推奨するタイプが選ばれている割合は２５％にとどまった。

Translation

   

Nearly 60% of the antimicrobial (antibiotics) prescribed at outpatient clinics in Japan for viral infectious diseases were unnecessary prescriptions such as being not effective for colds, according to a research team from Jichi Medical University and others. Seventy-five percent were drugs not recommended by specialists. Researchers were calling for the right use of antibiotics as improper use could lead to drug-resistant bacteria.

The team surveyed antimicrobial drugs prescribed in outpatient clinics in 2012- 2014 nationwide based on data from medical treatments such as prescriptions (receipt) and the illnesses etc. that they were targeting at. Annually there were about 8.957 million prescriptions on average. There were 704 prescriptions per 1,000 people, 1.4 times higher than in the United States.

Only 8% of prescriptions were prescribed for diseases that required antibiotics. Fifty-six percent of those prescribed were usually caused by a virus, such as a cold or acute bronchitis. Antibiotics were treatments for bacterial infections and had no effect on viral infections. In addition, while there were 36% prescriptions for acute pharyngitis (tontoitis) and acute sinusitis, bacteria caused 10-20% of the cases, so it seemed that many were prescribed towards the virus ineffectively.

Eighty-six percent of the prescribed antibacterial drugs were called “Broad spectrum antibacterial drugs” that worked against various kinds of bacteria. It was rarely used in Europe because of its ability to develop resistant bacteria and its easy proliferation. Only 25% of the types recommended by specialists were chosen.

              It is surprising to note that so many doctors in Japan were prescribing antibiotics to cure colds etc. knowing that they were ineffective.