AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, Japan; Collaborative Chairs Emerging and Reemerging Infectious Diseases, National Center for Global Health and Medicine, Graduate School of Medicine, 1-1, Seriryo-tyo, Aoba-ku, Sendai, Miyagi, Japan.
AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, Japan.
Int J Infect Dis. 2021 Feb;103:154-156. doi: 10.1016/j.ijid.2020.11.158. Epub 2020 Nov 20.
The aim of this study was to estimate the effects of Japan's National Action Plan on Antimicrobial Resistance 2016-2020 (NAP) on antimicrobial use (AMU). Monthly AMU from January 2013 to December 2019 was calculated using sales data, and time-series charts of AMU were then created for the total antimicrobials and target drug categories shown in the NAP (oral cephalosporins, oral fluoroquinolones, oral macrolides, and parenteral antimicrobials). Twelve-month predictions were generated to evaluate AMU in 2020. The publication of the NAP was associated with an AMU reduction in total antimicrobials, cephalosporins, fluoroquinolones, and macrolides. Parenteral AMU showed an upward trend, although it was not significantly associated with the intervention effect. AMU reductions of 15.0% for total antimicrobials, 26.3% for cephalosporins, 23.5% for fluoroquinolones, and 24.6% for macrolides were predicted for 2020 relative to 2013. However, there was a predicted increase of 17.4% for parenteral AMU. While Japan's NAP has contributed to the reduction in national AMU over the past 5 years, sustained action is still needed to further improve antimicrobial stewardship and promote countermeasures to antimicrobial resistance.
本研究旨在评估日本 2016-2020 年国家抗菌药物管理计划（NAP）对抗菌药物使用（AMU）的影响。使用销售数据计算了 2013 年 1 月至 2019 年 12 月的每月 AMU，并为 NAP 中显示的总抗菌药物和目标药物类别（口服头孢菌素、口服氟喹诺酮类、口服大环内酯类和注射用抗菌药物）创建了 AMU 时间序列图。生成了 12 个月的预测值，以评估 2020 年的 AMU。NAP 的发布与总抗菌药物、头孢菌素、氟喹诺酮类和大环内酯类的 AMU 减少有关。虽然与干预效果没有显著关联，但注射用 AMU 呈上升趋势。与 2013 年相比，预计 2020 年总抗菌药物、头孢菌素、氟喹诺酮类和大环内酯类的 AMU 将分别减少 15.0%、26.3%、23.5%和 24.6%。然而，预计注射用 AMU 将增加 17.4%。尽管日本的 NAP 在过去 5 年中有助于减少国家 AMU，但仍需要持续采取行动，以进一步改善抗菌药物管理并促进对抗微生物药物耐药性的对策。
