1047. Outpatient Antimicrobial Consumption and Frequency of Resistance in Suwa area, Nagano, Japan
Session: Poster Abstract Session: Stewardship: Improving Treatments
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
  • 131005 Suwa consumption IDSA poster3.pdf (475.0 kB)
  • Background: The public health community faces the global challenge posed by antimicrobial-resistant bacteria. Therefore, trends in antimicrobial consumption should be identified to estimate selective pressure on resistance and enhance the management of antimicrobials in hospitals and communities. Although the European Union has established methods for the surveillance of antimicrobial use and resistance, other countries including the United States and Japan have no comprehensive surveillance systems in place.

    Methods: Records on outpatient antimicrobial prescriptions in Suwa area, Nagano prefecture, Japan were collected between January and December 2010 from a national health insurance electronic database. The defined daily dose (DDD) per 1,000 inhabitants per day was calculated for each antimicrobial category based on the World Health Organization’s Anatomical Therapeutic Chemical (ATC)/DDD system. Records on antimicrobial-resistant bacteria were collected during the same period from area hospitals. The results were compared with European data.

    Results: The target population was 31,539 (27.1%) of the total area population. Total outpatient antimicrobial use was 9.6 DDD per 1,000 inhabitants per day. Macrolide, lincosamide, and streptogramin antibiotics (MLS) was the most frequently prescribed drug group (42%), followed by beta-lactams other than penicillins (25%) and quinolones (19%). Penicillins accounted for only 5.8% of the total number of prescribed antimicrobials. Seasonal variation in antimicrobial use was observed. The quinolone-resistance rate among Escherichia coli in this area was within the predicted range based on the European data; however, macrolide-resistance rates for Streptococcus pneumoniae exceeded these limits.

    Conclusion: Antimicrobial consumption in the study area is lower than in European countries and the pattern of use by antimicrobial category is different. The health insurance system electronic database proved a useful way to collect data on antimicrobial use in efforts to develop strategies aimed at curbing antimicrobial resistance, such as antimicrobial stewardship in Japan.

    Yoshiaki Gu, MD, MPH1, Etsuji Okamoto, MD, MPH2, Hajime Kanamori, MD, PhD, MPH3, Shiro Endo, MD, PhD3, Tetsuji Aoyagi, MD, PhD3, Masumitsu Hatta, MD, PhD3, Koichi Tokuda, MD, PhD, MPH3, Hisakazu Yano, MD, PhD3 and Mitsuo Kaku, MD, PhD3, (1)Department of Regional Cooperation for Infectious Diseases, Tohoku University Graduate School of Medicine, Sendai, Japan, (2)Department of Health and Welfare Service Research, National Institute of Public Health, Wako, Japan, (3)Department of Infection Control and Laboratory Diagnostics, Tohoku University Graduate School of Medicine, Sendai, Japan


    Y. Gu, None

    E. Okamoto, None

    H. Kanamori, None

    S. Endo, None

    T. Aoyagi, None

    M. Hatta, None

    K. Tokuda, None

    H. Yano, None

    M. Kaku, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.