A nationwide survey of intravenous antimicrobial use in intensive care units in Japan.

dc.contributor.author

Ohnuma, Tetsu

dc.contributor.author

Hayashi, Yoshiro

dc.contributor.author

Yamashita, Kazuto

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Marquess, John

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Lefor, Alan Kawarai

dc.contributor.author

Sanui, Masamitsu

dc.contributor.author

Japanese Survey of AntimiCRobial Use in ICU PatienTs (JSCRIPT) investigators

dc.date.accessioned

2020-08-21T23:15:23Z

dc.date.available

2020-08-21T23:15:23Z

dc.date.issued

2018-04

dc.date.updated

2020-08-21T23:15:22Z

dc.description.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; Pā€‰=ā€‰0.033) and an open ICU (adjusted odds ratio, 2.30; 95% CI, 1.02-5.17; Pā€‰=ā€‰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.

dc.identifier

S0924-8579(18)30033-5

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1872-7913

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1872-7913

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https://hdl.handle.net/10161/21337

dc.language

eng

dc.publisher

Elsevier BV

dc.relation.ispartof

International journal of antimicrobial agents

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10.1016/j.ijantimicag.2018.01.022

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Japanese Survey of AntimiCRobial Use in ICU PatienTs (JSCRIPT) investigators

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Humans

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Carbapenems

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Anti-Bacterial Agents

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Cross-Sectional Studies

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Drug Resistance, Multiple, Bacterial

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Aged

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Intensive Care Units

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Japan

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Female

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Male

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Drug Prescriptions

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Administration, Intravenous

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Surveys and Questionnaires

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Antimicrobial Stewardship

dc.title

A nationwide survey of intravenous antimicrobial use in intensive care units in Japan.

dc.type

Journal article

pubs.begin-page

636

pubs.end-page

641

pubs.issue

4

pubs.organisational-group

Staff

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Anesthesiology

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Duke

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Clinical Science Departments

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School of Medicine

pubs.publication-status

Published

pubs.volume

51

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