Maruyama Kohei, Sekiya Kiyoshi, Yanagida Noriyuki, Yasuda Shuhei, Fukumoto Daisuke, Hosoya Satoshi, Moriya Hiromitsu, Takahashi Kyohei, Komatsu Toshiaki
Division of Antimicrobial Stewardship Program, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan; Department of Pharmacy, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
Division of Antimicrobial Stewardship Program, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan; Department of Allergy and Respirology, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
J Infect Chemother. 2025 Apr;31(4):102636. doi: 10.1016/j.jiac.2025.102636. Epub 2025 Jan 30.
To date, no studies have specifically addressed seasonal variation in the use of intravenous broad-spectrum antimicrobials. This study aimed to examine the seasonal patterns of the use of intravenous broad-spectrum antimicrobials by utilizing a nationwide Japanese infection control surveillance database.
This retrospective cohort study extracted the days of therapy (DOT) for intravenous broad-spectrum antimicrobials and the detection rates of drug-resistant bacteria from the database between 2018 and 2023. Seasonal variation was analyzed using these values through seasonal and trend decomposition using loess.
The DOT for carbapenems, tazobactam/piperacillin, fourth-generation cephalosporins, and fluoroquinolones showed seasonal variation, peaking in fall. Conversely, no significant seasonal variation was observed in the DOT for anti-methicillin-resistant Staphylococcus aureus (MRSA) agents. The detection rates of Pseudomonas aeruginosa, Klebsiella aerogenes, and Enterobacter cloacae exhibited seasonal variation and peaked in fall. The detection rates of Enterococcus faecium exhibited seasonal variation as well, though no distinct peaks were observed. There was no significant seasonal variation in the detection rates of third-generation cephalosporin-resistant Escherichia coli or MRSA.
The findings of this study indicate seasonal variation in the use of intravenous broad-spectrum antimicrobials. This seasonality was likely influenced by various factors, including the detection rates of drug-resistant bacteria. The study underscores the importance of appropriate antimicrobial stewardship and interventions against drug-resistant organisms, particularly during fall.
迄今为止，尚无研究专门探讨静脉注射广谱抗菌药物使用的季节性变化。本研究旨在利用日本全国感染控制监测数据库，研究静脉注射广谱抗菌药物使用的季节性模式。
这项回顾性队列研究从2018年至2023年的数据库中提取了静脉注射广谱抗菌药物的治疗天数（DOT）和耐药菌的检出率。通过使用局部加权回归法（loess）进行季节和趋势分解，利用这些值分析季节性变化。
碳青霉烯类、他唑巴坦/哌拉西林、第四代头孢菌素和氟喹诺酮类的DOT显示出季节性变化，在秋季达到峰值。相反，抗耐甲氧西林金黄色葡萄球菌（MRSA）药物的DOT未观察到明显的季节性变化。铜绿假单胞菌、产气克雷伯菌和阴沟肠杆菌的检出率呈现季节性变化，并在秋季达到峰值。粪肠球菌的检出率也呈现季节性变化，不过未观察到明显峰值。第三代头孢菌素耐药大肠杆菌或MRSA的检出率没有显著的季节性变化。
本研究结果表明静脉注射广谱抗菌药物的使用存在季节性变化。这种季节性可能受到多种因素的影响，包括耐药菌的检出率。该研究强调了适当的抗菌药物管理以及针对耐药菌的干预措施的重要性，尤其是在秋季。
