Fukuda Daisuke, Handa Yutaka, Kayama Yoko, Fujii Kenji, Kawamatsu Shinya, Kawano Yoshiaki, Vojtek Ivo, Powell Danielle, Mulgirigama Aruni, Gu Yoshiaki
Vaccine and Infectious Disease, GSK, Tokyo 107-0052, Japan.
Specialty Care, GSK, Tokyo 107-0052, Japan.
Antibiotics (Basel). 2025 Aug 8;14(8):813. doi: 10.3390/antibiotics14080813.
Antimicrobial resistance (AMR) has reached a critical situation globally, prompting urgent national responses to this escalating crisis, including the prioritization of novel antibiotic research. In 2016, Japan initiated a national AMR action plan that promoted appropriate antibiotic use in the country and encouraged a national environment conducive to mitigation measures. However, tackling AMR remains difficult. From an epidemiological perspective, this challenge now extends beyond severe infections, impacting common community-acquired infections, including uncomplicated urinary tract infections (uUTls) and gonorrhea. In uUTIs, the rising prevalence of extended-spectrum β-lactamase-producing and fluoroquinolone-resistant diminishes the effectiveness of current, routinely used oral antibiotics, necessitating an exploration into innovative solutions. Similarly, the growing resistance of to antibiotics such as azithromycin raises concerns about the efficacy of current therapeutic options for gonorrhea, which is a highly prevalent sexually transmitted infection. In Japan, since the removal of azithromycin as the recommended first-line treatment, there are no oral first-line antibiotics available to treat gonorrhea. Therefore, novel oral antibiotics are urgently needed for both serious and commonly occurring community-acquired infections. This narrative review discusses the limited availability of novel antibiotics in Japan, the distinctive features of the Japanese antibiotic repertoire and AMR epidemiology, and potential alternative oral treatments for community-acquired infections, including uUTIs and gonorrhea. Japan has been making significant advances toward tackling the AMR crisis through an updated national action plan, AMR policy changes, and innovative approaches to developing novel antibiotics. Substantial international cooperation and the engagement of diverse industry sectors are essential to address the pressing issue of AMR.
抗菌药物耐药性（AMR）在全球已达到危急状况，促使各国针对这一日益严重的危机迅速做出反应，包括将新型抗生素研究列为优先事项。2016年，日本启动了一项全国性的AMR行动计划，该计划促进了该国抗生素的合理使用，并营造了有利于缓解措施的全国性环境。然而，应对AMR仍然困难重重。从流行病学角度来看，这一挑战现已超出严重感染范围，影响到常见的社区获得性感染，包括单纯性尿路感染（uUTIs）和淋病。在uUTIs中，产超广谱β-内酰胺酶和耐氟喹诺酮类细菌的患病率不断上升，降低了当前常规使用的口服抗生素的有效性，因此有必要探索创新解决方案。同样，淋病奈瑟菌对阿奇霉素等抗生素的耐药性不断增强，引发了人们对当前淋病治疗方案疗效的担忧，淋病是一种高度流行的性传播感染。在日本，自阿奇霉素不再作为推荐的一线治疗药物后，已没有可用于治疗淋病的口服一线抗生素。因此，无论是严重的还是常见的社区获得性感染，都迫切需要新型口服抗生素。本叙述性综述讨论了日本新型抗生素供应有限的情况、日本抗生素种类及AMR流行病学的独特特征，以及针对社区获得性感染（包括uUTIs和淋病）的潜在替代口服治疗方法。日本通过更新全国行动计划、AMR政策变化以及开发新型抗生素的创新方法，在应对AMR危机方面取得了重大进展。大量的国际合作和不同行业部门的参与对于解决紧迫的AMR问题至关重要。
