Vol.66 No.6 November 2018

The current status and issue of usage of intravenous antimicrobial agents in national and public university hospitals in Japan

Koichi Izumikawa^1,2), Takashi Tomita^1,3), Nobuhiro Nishimura^1,4), Takashi Niwa^1,5), Kazuo Takayama^1,6), Noboru Ohana^1,7), Fumiko Kusama^1,8), Yukio Hida^1,9), Kiyoshi Negayama^1,10), Junichi Matsuda^1,11), Makoto Katsumi^1,12), Tomoaki Sato^1,13), Yutaka Tokue^1,14) and Nobuo Murakami^1,15)

¹⁾Japan Infection Prevention and Control Conference for National and Public University Hospitals
²⁾Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan
³⁾Department of Pharmaceutical Services, Hiroshima University Hospital
⁴⁾Department of Pharmacy, Shimane University Hospital
⁵⁾Department of Pharmacy, Gifu University Hospital
⁶⁾Department of Pharmacy, Tokyo University Hospital
⁷⁾Department of Clinical Laboratory Medicine, Fukushima Medical University Hospital
⁸⁾Clinical Laboratory Medicine, Niigata University Medical & Dental Hospital
⁹⁾Department of Clinical Laboratories, University of Fukui Hospital
¹⁰⁾Department of Clinical Laboratory, Kagawa University Hospital
¹¹⁾Department of Laboratory Medicine, Nagasaki University Hospital
¹²⁾Department of Laboratory Medicine, Tohoku University Hospital
¹³⁾Department of Laboratory Medicine, The University of Tokyo Hospital
¹⁴⁾Infection Control and Prevention Center, Gunma University Hospital
¹⁵⁾Center for Nutrition Support and Infection Control, Gifu University Hospital

Abstract

National action plans to manage antimicrobial resistance were proposed by the Ministry of Health, Labour and Welfare in 2016 in Japan. Various plans, including plans to ensure appropriate use of antibiotics, have been proposed. We analyzed the national data on the rate of emergence of major drug-resistant bacteria and usage rate of intravenous antibiotics in Japan, based on the data from surveillance, results of a survey conducted by lab technician and pharmacy group of the Japan Infection Prevention and Control Conference for National and Public University Hospitals. Carbapenem-resistant enterobacteriaceae were isolated from 657 cases in 2015. The number of isolates of extended-spectrum β -lactamase-producing bacteria has increased significantly, although the number of multi-drug resistant Pseudomonas species, including those resistant to at least two anti-pseudomonal drugs are levelling off annually. The rate of use of intravenous antibiotics has steadily increased. In particular, the rate of use of intravenous penicillins has increased dramatically, as has that of carbapenems, although the latter, not significantly. Carbapenems are used evenly at university hospitals, while the tazobactam/piperacillin differs among university hospitals. It is important that national action plans for combating drug-resistant bacteria are firmly executed in Japan, so as to ensure appropriate use of antibiotics and a reduced rate of emergence of drug-resistant bacteria.

Key word

national action plans on antimicrobial resistance, appropriate use of antimicrobials, national and public university hospitals, current status, parenteral antimicrobials

Received

March 22, 2018

Accepted

June 20, 2018

Jpn. J. Chemother. 66 (6): 738-748, 2018