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

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

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish
Pages (from-to)636-641
Number of pages6
JournalInternational Journal of Antimicrobial Agents
Volume51
Issue number4
DOIs
Publication statusPublished - Apr 2018

Fingerprint

Intensive Care Units
Japan
Anti-Bacterial Agents
Carbapenems
Prescriptions
Odds Ratio
Intraabdominal Infections
Microbial Sensitivity Tests
Critical Care
Communicable Diseases
Surveys and Questionnaires
Epidemiologic Studies
Referral and Consultation
Logistic Models
Regression Analysis
Infection

Keywords

  • Antimicrobial stewardship
  • Antimicrobial use
  • Carbapenem
  • Drug resistance
  • Intensive care unit

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

A nationwide survey of intravenous antimicrobial use in intensive care units in Japan. / Japanese Survey of AntimiCRobial Use in ICU PatienTs (JSCRIPT) investigators.

In: International Journal of Antimicrobial Agents, Vol. 51, No. 4, 04.2018, p. 636-641.

Research output: Contribution to journalArticle

Japanese Survey of AntimiCRobial Use in ICU PatienTs (JSCRIPT) investigators. / A nationwide survey of intravenous antimicrobial use in intensive care units in Japan. In: International Journal of Antimicrobial Agents. 2018 ; Vol. 51, No. 4. pp. 636-641.
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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.",
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