What the US could learn from Japan's incentive for responsible antibiotic use

'A silent pandemic': How Japan is curbing antibiotic resistance, $5 at a time This is the fifth and final story in a series about antibiotic use in Japan and the U.S.

I've explored how a Japanese program reduces antibiotic misuse while also unpacking the factors that drive that misuse in the first place.

Now, I'll examine whether the context in the U.S. is similar enough to Japan that lessons from one country can carry over to the other.

When penicillin was first introduced to the public, it earned the nickname "the wonder drug" because it cured infections that had once been deadly.

It ushered in the golden era of antibiotics, during which the bacteria-killing drugs entered widespread use, driving down rates of severe disease and death from infections.

Unfortunately, the sweeping adoption of these medicines also set the stage for their obsolescence.

Once hailed as miracles, antibiotics are now losing their power as bacteria evolve strategies to evade them.

Today, the world is contending with a "silent pandemic" of antibiotic resistance, driven largely by the misuse and overuse of these critical medicines.

Curbing resistance, then, means changing how doctors prescribe ‪—‬ and patients use ‪—‬ antibiotics.

I traveled to Japan because a government initiative aimed at correcting antibiotic misuse has helped slash unnecessary prescribing and I wondered if a similar approach could work in the U.S.

The program offers "tips" of 800 yen (about $5) to the clinics of pediatricians and ear, nose and throat doctors (ENTs) who withhold antibiotics in cases when they're likely not needed.

My findings suggest that many of the factors that drive antibiotic misuse in outpatient clinics overlap in the U.S. and Japan.

But the cultural, governmental and insurance landscape may differ too greatly between the two countries for America to copy-and-paste Japan's approach.

Instead, here's what I think could work to close the gaps in antibiotic overprescription in the U.S., based on my conversations with doctors.