Home visit survey on outpatient antibiotic use: Assessing leftover medications and factors influencing appropriate use by community Pharmacists.

Abstract

This cross-sectional study investigated the prevalence and factors associated with leftover antibiotics in Japanese households through pharmacist home visits. The research, conducted in collaboration with pharmaceutical associations in Kyoto and Hirakata, included 37 cases analyzed from October 2023 to March 2024. Participants had a median age of 81 years and received a median of two antibiotic prescriptions in the past year. Leftover antibiotics were found in 18.9 % of cases, with 5 out of 7 cases resulting from prophylactic prescriptions. Levofloxacin was the most common leftover antibiotic. Notably, 27.0 % of participants reported a history of reusing leftover antibiotics. Logistic regression analysis revealed that frequent pharmacist visits (≥2/month) were significantly associated with decreased leftover antibiotics (adjusted OR: 0.02, 95 % CI: 0.00-0.48, p = 0.015), whereas a history of antibiotic reuse increased the likelihood of leftovers (adjusted OR: 20.32, 95 % CI: 1.78-231.33, p = 0.015). Other factors, including the number of antibiotic prescriptions and the presence of medication support, did not show statistically significant associations. This study highlights the potential role of community pharmacists in promoting appropriate antibiotic use and managing leftover medications through home healthcare engagement. The findings suggest that regular pharmacist interventions could significantly improve medication management and contribute to antimicrobial stewardship efforts. Future research should replicate these findings in larger, more diverse populations to enhance generalizability and further explore the long-term impact of pharmacist interventions on antibiotic use patterns.