Vol.69 No.3 May 2021
Changes in the pattern of use of oral third-generation cephalosporins and their association with the outcomes of ophthalmic day surgeries
1)Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, Japan
2)Department of Pharmacy, Kobe City Eye Hospital
3)Department of Infectious Diseases, Kobe City Medical Center General Hospital
4)Department of Ophthalmology, Kobe City Eye Hospital
Abstract
The Japanese Ministry of Health, Labour and Welfare implemented the National Action Plan on Antimicrobial Resistance in 2016 and emphasized the necessity of implementation of antimicrobial stewardship (AS). The prescription frequency of oral third-generation cephalosporins appears to be higher in Japan than in other countries. Therefore, we attempted to promote appropriate use of these cephalosporins.
Cefcapene pivoxil, an oral third-generation cephalosporin, was designated as an antimicrobial agent for prophylactic use after ophthalmic day surgeries at our hospital. However, use of this antibiotic accounted for a high proportion of antimicrobial agent use at the hospital (before AS). At our hospital, before the establishment of the antimicrobial stewardship team (AST), an infection control team (ICT) had been supporting the proper use of antimicrobial agents. In November 2016, we deregistered cefcapene pivoxil tablets from the clinical pathway for ophthalmic day surgeries (after AS).
We investigated the changes in prescriptions, incidence of endophthalmitis and costs before and after AS at our hospital, so as to ensure appropriate use of cefcapene pivoxil tablets after ophthalmic day surgeries.
The percentage and costs of prescriptions of cefcapene pivoxil tablets decreased significantly after AS (p<0.001); however, no effect of implementation of AS was observed on the incidence of endophthalmitis.
Efforts at AS contributed to improving the quality of medical care.
Key word
antimicrobial stewardship, oral third-generation cephalosporins, endophthalmitis, outpatient
Received
September 4, 2019
Accepted
December 9, 2020
Jpn. J. Chemother. 69 (3): 249-254, 2021
