Antimicrobial use in Japanese hospitals: results from point prevalence survey in Aichi, 2020.

Background: Comprehensive antimicrobial use (AMU) data are essential to promote effective antimicrobial stewardship. However, qualitative information on AMUs in Japanese hospitals is limited.

Objective: This study aimed to provide an overview of AMU for inpatients in Japanese hospitals.

Methods: A multicentre point-prevalence survey was conducted across Aichi Prefecture in 2020, collecting patient demographics, underlying conditions, indications of AMU (for treatment of community-acquired infections [CAIs]/healthcare-associated infections [HAIs], surgical prophylaxis [SP], medical prophylaxis [MP] and others), treated infections, and antimicrobial stewardship team (AST) intervention.

Results: Among the 10,199 patients from 27 hospitals included in this study, A total of 3,738 antimicrobials were prescribed to 3,024 patients (29.6%; 95% confidence interval: 28.8-30.5). Of these, 1,510 (40.4%) antimicrobials were prescribed for CAI treatment, 815 (21.8%) for HAI treatment, 745 (19.9%) for SP, and 639 (17.1%) for MP. SP administration over 2 days was observed in 31.2% of the cases. The top three prescribed antimicrobials were cefazolin (12.0%, 450), ceftriaxone (9.2%, 343), and oral trimethoprim-sulfamethoxazole (8.7%, 327). Antimicrobial use per 1,000 patients was highest in extra-large hospitals (472) and lowest in small hospitals (264). Ceftriaxone was most commonly prescribed for CAIs, while meropenem was typical for HAIs. AST intervention rates were 15.0% and 22.5% in CAIs and HAIs, respectively.

Conclusions: This study provides comprehensive AMU information from a region in Japan, highlighting variations linked to hospital size, frequent prescriptions of broad-spectrum antimicrobials for HAIs, high prescription rate of trimethoprim-sulfamethoxazole as MP, and prolonged SAP.