{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:47:51Z","timestamp":1782920871815,"version":"3.54.5"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["24K10538"],"award-info":[{"award-number":["24K10538"]}]},{"name":"Strategic Innovation Promotion Programme","award":["JPJ012425"],"award-info":[{"award-number":["JPJ012425"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Research on the effectiveness of Japan\u2019s national action plan on antimicrobial resistance, including among individuals with HIV, remains scarce.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate the impact of policies on antibiotic prescription practices.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Outpatient oral antibiotic prescription data from 2012 to 2020 were extracted from a national claims database comprising &amp;gt;98% of the Japanese population. Prescription rates were stratified according to antibiotic class, diagnosis and HIV status. An interrupted time-series analysis was performed to assess the impact of the national action plan.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>An average of 129,989,400 prescriptions were issued annually (1024 per 1000 population-years). Between 2012 and 2020, the oral antibiotic prescription rate decreased by 54%. The prescription rate showed a significant downward trend post-intervention (additional annual reduction in incidence rate ratio, 0.889; 95% confidence interval, 0.889\u20130.990). However, broad-spectrum antibiotics (third-generation cephalosporins, macrolides and fluoroquinolones) remained prevalent, comprising 84.7% and 71.4% of prescriptions in 2012 and 2020, respectively. Antibiotic prescriptions during outpatient visits for pharyngitis, sinusitis, bronchitis and viral upper respiratory infections decreased significantly (rate ratios\u200a=\u200a0.66, 0.76, 0.51 and 0.49, respectively). The antibiotic prescription rate was \u223c2.5-fold higher in individuals with HIV than in those without.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Antibiotic prescription rates significantly decreased following the implementation of the national action plan. However, a sharp decline in 2020, likely due to the coronavirus disease pandemic, requires continued rebound monitoring. Reducing broad-spectrum oral antibiotic overuse remains a critical focus.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaf062","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T10:13:44Z","timestamp":1746008024000},"source":"Crossref","is-referenced-by-count":5,"title":["Significant reduction in antibiotic prescription rates in Japan following implementation of the national action plan on antimicrobial resistance (2016\u201320): a 9-year interrupted time-series analysis"],"prefix":"10.1093","volume":"7","author":[{"given":"Hideki","family":"Hashimoto","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Jichi Medical University Hospital , 3311-1 Yakushiji, Shimotsuke-shi, Tochigi 329-0498 ,","place":["Japan"]},{"name":"Hitachi Social Cooperation Education Research Centre, University of Tsukuba Hospital , 2-1-1 Jonancho, Hitachi-shi, Ibaraki 317-0077 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Kanda","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Jichi Medical University Hospital , 3311-1 Yakushiji, Shimotsuke-shi, Tochigi 329-0498 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromasa","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Department of Research, Institute for Health Economics and Policy , 1-5-11, Nishi-Shimbashi, Minato-ku, Tokyo 105-0003 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Goda","sequence":"additional","affiliation":[{"name":"Institute of Industrial Science, The University of Tokyo , 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohiro","family":"Mitsutake","sequence":"additional","affiliation":[{"name":"Department of 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