A nationwide survey of intravenous antimicrobial use in intensive care units in Japan.
Abstract
Although most patients in the intensive care unit (ICU) receive antibiotics, little
is known about patterns of antibiotic use in ICUs in Japan. The objective of this
study was to evaluate the pattern of antibiotic use in ICUs. A nationwide one-day
cross-sectional surveillance of antibiotic use in the ICU was conducted three times
between January 2011 and December 2011. All patients aged at least16 years were included.
Data from 52 ICUs and 1148 patients were reviewed. There were 1028 prescriptions for
intravenous antibiotics. Of 1148 patients, 834 (73%) received at least one intravenous
antibiotic, and 575 had at least one known site of infection. Respiratory and intra-abdominal
infections were the two most common types. Of 1028 prescriptions, 331 (34%) were for
surgical or medical prophylaxis. Excluding prophylaxis, carbapenems were the most
commonly prescribed agent. Infectious disease consultations, pre- and post-prescription
antimicrobial stewardship, and ICU-dedicated antibiograms were available in 44%, 52%,
77%, and 21% of the ICUs, respectively. In logistic regression analysis adjusting
for patient characteristics, treatment in a university hospital (adjusted odds ratio,
1.72; 95% CI, 1.05-2.84; P = 0.033) and an open ICU (adjusted odds ratio, 2.30; 95%
CI, 1.02-5.17; P = 0.044) were significantly associated with greater likelihood of
carbapenem use. An increase in the number of closed ICUs and more intensive care specialists
may reduce carbapenem use in Japanese ICUs. Large-scale epidemiological studies of
antimicrobial resistance in the ICU are needed.
Type
Journal articleSubject
Japanese Survey of AntimiCRobial Use in ICU PatienTs (JSCRIPT) investigatorsHumans
Carbapenems
Anti-Bacterial Agents
Cross-Sectional Studies
Drug Resistance, Multiple, Bacterial
Aged
Intensive Care Units
Japan
Female
Male
Drug Prescriptions
Administration, Intravenous
Surveys and Questionnaires
Antimicrobial Stewardship
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https://hdl.handle.net/10161/21337Published Version (Please cite this version)
10.1016/j.ijantimicag.2018.01.022Publication Info
Ohnuma, Tetsu; Hayashi, Yoshiro; Yamashita, Kazuto; Marquess, John; Lefor, Alan Kawarai;
Sanui, Masamitsu; & Japanese Survey of AntimiCRobial Use in ICU PatienTs (JSCRIPT)
investigators (2018). A nationwide survey of intravenous antimicrobial use in intensive care units in Japan.
International journal of antimicrobial agents, 51(4). pp. 636-641. 10.1016/j.ijantimicag.2018.01.022. Retrieved from https://hdl.handle.net/10161/21337.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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