Financial Incentives Reduce Unnecessary Antibiotics for Pediatric URIs, GE

Background: Overuse of antibiotics remains a significant global health problem. While financial incentives have been shown to impact antibiotic prescribing in the short term, the long-term benefits remain unclear. Objective: To evaluate the short- and long-term impact of a program to incentivize appropriate non-prescription of antibiotics within the National Action Plan on Antimicrobial Resistance in Japan for children with acute upper respiratory infections (URIs) and gastroenteritis (GE). Design: Quasi-experimental staggered difference-in-differences study based on 2 nationwide databases. Methods: Records of children born between April 2017 and March 2019 with available data were tracked until 2022. The National Action Plan on Antimicrobial Resistance was implemented in April 2018 and offered financial rewards for facilities where physicians (1) diagnosed children with URIs or GE, (2) explained the rationales for non-prescribing of antibiotics, and (3) provided guidance for home ca more...