Nationwide surveillance of antimicrobial consumption and resistance to Pseudomonas aeruginosa isolates at 203 Japanese hospitals in 2010
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In Japan, a national surveillance study of antimicrobial consumption has never been undertaken. This study aimed to describe antimicrobial consumption and resistance to Pseudomonas aeruginosa in 203 Japanese hospitals, to identify targets for quality improvement.
We conducted an ecological study using retrospective data (2010). Antimicrobial consumption was collected in the World Health Organization (WHO) anatomical therapeutic chemical/defined daily dose (ATC/DDD) format. Rates of imipenem (IPM), meropenem (MEPM), ciprofloxacin (CPFX), or amikacin (AMK) resistance were expressed as the incidence of non-susceptible isolates. Additionally, hospitals were asked to provide data concerning hospital characteristics and infection control policies. Hospitals were classified according to functional categories of the Medical Services Act in Japan.
Data were collected from 203 Japanese hospitals (a total of 91,147 beds). The total antimicrobial consumption was 15.49 DDDs/100 bed-days (median), with consumptions for penicillins, carbapenems, quinolones, and glycopeptides being 4.27, 1.60, 0.41, and 0.49, respectively. The median incidences of IPM, MEPM, CPFX, and AMK resistance were 0.15, 0.10, 0.13, and 0.03 isolates per 1,000 patient-days, respectively. Antimicrobial notification and/or approval systems were present in 183 hospitals (90.1 %). In the multivariate analysis, the piperacillin/tazobactam, quinolones, and/or total consumptions and the advanced treatment hospitals showed a significant association with the incidence of P. aeruginosa resistant to IPM, MEPM, CPFX, and AMK [adjusted R 2 (aR 2) values of 0.23, 0.30, 0.22, and 0.35, respectively).
This is the first national surveillance study of antimicrobial consumption in Japan. A continuous surveillance program in Japan is necessary in order to evaluate the association among resistance, antimicrobial restriction, and consumption.
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- Nationwide surveillance of antimicrobial consumption and resistance to Pseudomonas aeruginosa isolates at 203 Japanese hospitals in 2010
Volume 41, Issue 2 , pp 415-423
- Cover Date
- Print ISSN
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- Additional Links
- Antimicrobial consumption
- Anatomical Therapeutic Chemical
- Defined daily dose
- Industry Sectors
- Author Affiliations
- 1. The Fifth Subcommittee, Committee on Academic, Japanese Society of Hospital Pharmacists, Tokyo, Japan
- 2. Department of Pharmacy, Faculty of Medicine, Mie University Hospital, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
- 3. Department of Pharmacy, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
- 4. Department of Pharmacy, Osaka Rosai Hospital, Sakai, Osaka, Japan
- 5. Department of Hospital Pharmacy, Nagasaki University Hospital, Nagasaki, Japan
- 6. Faculty of Pharmacy, Meijo University, Nagoya, Aichi, Japan
- 7. Department of Pharmacy, Kagawa Rosai Hospital, Marugame, Kagawa, Japan
- 8. Department of Pharmacy, Niitsu Medical Center Hospital, Niigata, Niigata, Japan
- 9. Faculty of Pharmaceutical Sciences, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan
- 10. Department of Pharmacy, Narita Hospital, Japanese Red Cross Society, Narita, Chiba, Japan
- 11. Department of Pharmacy, Kyushu Kosei Nenkin Hospital, Kitakyushu, Fukuoka, Japan
- 12. Department of Translational Medical Science, Mie University Graduate School of Medicine, Tsu, Mie, Japan
- 13. Department of Pharmacy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
- 14. Department of Pharmacy, Yamagata University Hospital, Yamagata, Yamagata, Japan