Inappropriate Antibiotic Use for Acute Asthma in Japanese Emergency Departments
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- Tanaka Kenzo
- Emergency and Trauma Center, Kameda Medical Center
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- Gibo Koichiro
- Department of Emergency Medicine, Okinawa Prefectural Chubu Hospital
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- Watase Hiroko
- Department of Radiology, University of Washington
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- Oohashi Masaki
- Emergency and Trauma Center, Kameda Medical Center
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- Camargo Carlos A. Jr.
- Harvard Medical School
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- Hasegawa Kohei
- Harvard Medical School Department of Emergency Medicine, Massachusetts General Hospital
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- on behalf of the Japanese Emergency Medicine Network Investigators
- Emergency and Trauma Center, Kameda Medical Center
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抄録
Background: Little is known about the extent that acute asthma is inappropriately treated with antibiotics in Japanese emergency departments (EDs).Objectives: We examined the proportion and predictors of inappropriate antibiotic use for adults with acute asthma in the Japanese EDs.Methods: We conducted a chart review study in 23 Japanese EDs. Subjects were ED patients aged 18 to 54 years with acute asthma between 2009 and 2011. To examine predictors of inappropriate antibiotic use, we performed multi-level logistic regression analysis at both the patient- and ED-level modeling EDs as a random variable.Results: Among 1380 patients in the overall study, the analytic cohort comprised 1311 patients. Overall, antibiotics were inappropriately prescribed for 4.4% (95% confidence interval [CI], 3.4%–5.7%). In the multi-level logistic regression analysis, higher annual ED asthma visit volume was significantly associated with a lower proportion of inappropriate antibiotic use (odds ratio per 100-visit increase, 0.3 ; 95%CI, 0.2–0.6).Conclusions: In this large multicenter study in Japan, we found that approximately 4% of ED patients with acute asthma were inappropriately treated with antibiotics. We also demonstrated that the inappropriate use of antibiotics largely differed across the EDs and was less common in EDs with a more annual ED asthma visits. Organized knowledge translation initiatives are warranted to address this gap in emergency asthma care.
収録刊行物
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- Journal of General and Family Medicine
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Journal of General and Family Medicine 16 (4), 281-287, 2015
一般社団法人 日本プライマリ・ケア連合学会
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詳細情報 詳細情報について
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- CRID
- 1390001205762741504
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- NII論文ID
- 130005118295
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- ISSN
- 21897948
- 21896577
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
- CiNii Articles
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- 使用不可