AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan; Collaborative Chairs Emerging and Reemerging Infectious Diseases, National Center for Global Health and Medicine, Graduate School of Medicine, Tohoku University, 1-1, Seiryo-machi, Aobaku, Sendai-shi, Miyagi, 980-8574, Japan.
AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan; Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
J Infect Chemother. 2021 Jan;27(1):113-116. doi: 10.1016/j.jiac.2020.09.001. Epub 2020 Oct 1.
A large number of antibiotics are used for the treatment of uncomplicated cystitis owing to its high morbidity. As the administration of antibiotics for uncomplicated cystitis may be considered an example of inappropriate use, outpatient antimicrobial stewardship for this condition is important. We evaluated the current pharmacoepidemiology trends for the treatment of uncomplicated cystitis in Japan to predict stewardship strategies.
This descriptive observational study analyzed data from an anonymized claims database of employees and their family members covered by the employer's health insurance. We identified female outpatients diagnosed with acute cystitis (ICD-10 code N300) aged ≥15 years and extracted oral antibiotic prescription records between 2013 and 2016. We excluded prescriptions for >7 days.
The most prescribed antibiotic category was fluoroquinolones (52.67%), followed by cephalosporins and penems (40.63%). Third-generation cephalosporins accounted for 90.91% of cephalosporin and penem prescriptions. The most common duration of antibiotic prescription was 5 days, except for first-generation cephalosporins, penem (7 days) and sulfamethoxazole and trimethoprim (3 days).
Fluoroquinolones and third-generation cephalosporins were prescribed to most uncomplicated cystitis cases in Japan. Although the lack of alternatives to quinolones and beta-lactams in Japan is an obstacle for antimicrobial stewardship for uncomplicated cystitis, promoting accurate diagnoses and establishing alternatives available in the Japanese market are important. Shortening the treatment duration is also an important strategy. Further research is needed on local antimicrobial resistance patterns to determine a fixed treatment strategy for uncomplicated cystitis.
由于发病率高，大量抗生素被用于治疗单纯性膀胱炎。由于治疗单纯性膀胱炎可能被认为是不适当使用抗生素的一个例子，因此对这种疾病进行门诊抗菌药物管理非常重要。我们评估了日本治疗单纯性膀胱炎的当前药物流行病学趋势，以预测管理策略。
本描述性观察性研究分析了一项匿名索赔数据库的数据，该数据库涵盖了雇主健康保险覆盖的员工及其家属的信息。我们确定了≥15 岁的患有急性膀胱炎（ICD-10 编码 N300）的女性门诊患者，并提取了 2013 年至 2016 年的口服抗生素处方记录。我们排除了处方超过 7 天的患者。
处方最多的抗生素类别是氟喹诺酮类（52.67%），其次是头孢菌素类和青霉素类（40.63%）。头孢菌素和青霉素类处方中第三代头孢菌素占 90.91%。抗生素处方的最常见持续时间为 5 天，但第一代头孢菌素、青霉素（7 天）和磺胺甲噁唑和甲氧苄啶（3 天）除外。
氟喹诺酮类和第三代头孢菌素类被用于治疗日本大多数单纯性膀胱炎病例。尽管日本缺乏喹诺酮类和β-内酰胺类的替代品是单纯性膀胱炎抗菌药物管理的一个障碍，但促进准确诊断和建立日本市场上可用的替代品很重要。缩短治疗时间也是一个重要策略。需要对当地抗菌药物耐药模式进行进一步研究，以确定单纯性膀胱炎的固定治疗策略。
