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

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Ohnuma, T; Hayashi, Y; Yamashita, K; Marquess, J; Lefor, AK; Sanui, M; Japanese Survey of AntimiCRobial Use in ICU PatienTs (JSCRIPT) investigators,

Published Date

  • April 2018

Published In

Volume / Issue

  • 51 / 4

Start / End Page

  • 636 - 641

PubMed ID

  • 29408737

Pubmed Central ID

  • 29408737

Electronic International Standard Serial Number (EISSN)

  • 1872-7913

International Standard Serial Number (ISSN)

  • 0924-8579

Digital Object Identifier (DOI)

  • 10.1016/j.ijantimicag.2018.01.022

Language

  • eng