Vol.74 No.1 January 2026
Efficacy of carbapenem use reduction through antimicrobial stewardship activities targeting specific departments using the Japan Surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE) in medium-sized hospitals
1)Department of Pharmacy, Shinbeppu Hospital, 3898 Tsurumi, Beppu, Oita, Japan
2)Kyoto Pharmaceutical University Certificate Programme
Abstract
In small- and medium-sized hospitals with limited medical resources, the use of information technology is expected to support the promotion of antimicrobial stewardship (AS) activities; however, few studies have evaluated the impact of utilizing the Japan Surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE). At Shinbeppu Hospital, with the aim of reducing the use of carbapenems and thereby promoting appropriate antimicrobial use, AS activities were implemented using the J-SIPHE, combining hospital-wide information sharing with targeted interventions in departments with high carbapenem usage. The impact of these activities on the clinical outcomes was evaluated.
The study subjects included patients who were admitted to either the Respiratory Medicine Department or the Gastroenterology Department at our hospital between April 2021 and March 2023 and had received injectable antipseudomonal agents. The primary endpoint was days of therapy (DOT) for carbapenems, calculated on a monthly basis, at each of the two departments. The period from April 2021 to March 2022 was defined as the pre-intervention period, and that from April 2022 to March 2023 as the post-intervention period. In addition, we compared the use of injectable antipseudomonal agents (DOT, length of therapy, first selection rate, and de-escalation rate) at each of the two departments.
The target analysis included 140 patients in the pre-intervention period and 149 patients in the post-intervention period at the Respiratory Medicine Department, and 349 patients in the pre-intervention period and 261 patients in the post-intervention period at the Gastroenterology Department. The DOT for carbapenems decreased significantly post-intervention in both departments (Respiratory Medicine Department: 9.2 [7.9-11.7] vs. 7.6 [6.1-8.1], P=0.033; Gastroenterology Department: 9.3 [7.0-10.1] vs. 3.5 [2.8-3.9], P<0.001), and the first selection rate for carbapenems also decreased significantly in both departments (Respiratory Medicine Department: 65.0% vs. 38.9%, P<0.001; Gastroenterology Department: 33.8% vs. 15.3%, P<0.001). In contrast, no significant difference was observed in the duration of therapy or de-escalation rate post-intervention.
This study demonstrated that implementing AS activities using the J-SIPHE can reduce the use of carbapenems, even in medium-sized hospitals with limited medical resources.
Key word
medium-sized hospital, J-SIPHE, antimicrobial stewardship, carbapenem
Received
June 26, 2025
Accepted
September 22, 2025
Jpn. J. Chemother. 74 (1): 16-24, 2026
