National Action Plan on Antimicrobial Resistance (AMR) 2016-2020 and relevant activities in Japan

Abstract

includes "International Cooperation" as a unique 6th pillar additionally set in reference to the 5 pillars of the Global Action Plan, and a goal, strategy and countermeasures have been set for each area (Figure 1). Current status and challenges of antibiotic treatment in Japan The use of antibiotics in Japan is not particularly higher compared to that in Europe or the USA. However, in Japan oral antibiotics account for 92.4% of the total daily usage, and consists of third generation cephalosporins, macrolides and fluoroquinolone derivatives, which are so-called broad-spectrum antibiotics. Therefore, it is considered that the problem in Japan is the use of such broad-spectrum oral antibiotics (1). Higashi, et al. examined the national prescription database for the period from January to March 2005 and reported that approximately 60% of patients with non-bacterial upper respiratory tract infections were given antibiotics. The breakdown of the prescriptions was third generation cephalosporins (46%), macrolides (27%) and quinolones (16%) in descending order of frequency, and were prescribed more often at clinics than hospitals (2). Antibiotics may be prescribed to patients with the common cold for the purpose of pneumonia prophylaxis. Regarding this, a study was conducted to investigate how many patients with acute respiratory tract infection, including those with the common cold, need to be treated with antibiotics to prevent one patient from developing complications including pneumonia (3). The results showed that one case of complications could be prevented if 4,000 patients with acute respiratory tract infection would be given antibiotics. Considering the cost of antibiotics prescribed to 4,000 patients and the risks of adverse drug reactions and resistant bacteria, the prophylactic use of antibiotics to (71)

The safety and efficacy of relebactam/imipenem/cilastatin in Japanese patients with complicated intra-abdominal infection or complicated urinary tract infection: A multicenter, open-label, noncomparative phase 3 study

“…Similarly, Japan is focusing on measures against drug resistance. The Japanese government formulated a "National Action Plan on Antimicrobial Resistance" with one of its six objectives to promote research on antimicrobial resistance and research and development to prevent, diagnose and treat antimicrobial-resistant infections [4,5].…”

Review of Antimicrobial Resistance in Wastewater in Japan: Current Challenges and Future Perspectives

“…Azuma et al [ 46 ] compared the concentration of antimicrobial residues in hospital effluent with that in STP effluent and found that the concentration in the former was low and that most of the antimicrobials in STP effluent were from outside the hospital. In Japan, oral antimicrobials prescribed for an outpatient account for 92.4% of the total antimicrobials used daily, and most of them are used inappropriately [ 80 ]. Therefore, to reduce the burden of antimicrobials on the environment, efforts should be made to ensure that patients use oral antimicrobials correctly and that new technologies and strategies to treat antimicrobial agents in STP are developed and introduced.…”

Periodontal inflamed surface area in oral cavity associated with febrile neutropenia in patients with hematologic malignancy undergoing chemotherapy

“…Several reports have been presented indicating that fluoroquinolone prophylaxis is helpful for patients in whom FN was expected to occur for more than 7 days 35 , 36 , though resistance to Escherichia coli and Pseudomonas aeruginosa has been observed in association with that therapy. With the spread of antibiotic-resistant bacteria in medical treatment becoming a severe public health problem 35 , 37 , 38 , appropriate use of antimicrobial agents is required. Studies that evaluated fluoroquinolone prophylaxis efficacy have found that prevention of FN in high-risk patients has advantages for infectious complications and does not affect mortality 37 , 39 , 40 .…”