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

Ohnuma, Tetsu; Hayashi, Yoshihiko; Yamashita, Kazuto; Marquess, John; Lefor, Alan Kawarai; Sanui, Masamitsu

doi:10.1016/j.ijantimicag.2018.01.022

Cited by 5 publications

(5 citation statements)

References 24 publications

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“… 24 A single-centered prospective study in Belgium found 42% were prescribed prophylaxis 25 while a nationwide, single-day survey in 52 ICUs of Japan showed 34% of the prescriptions were prophylaxis intravenous (IV) antibiotics. 26 In the context of Nepal, the prophylactic use of antibiotic in MICU is not explicitly stated in the literature, but international guidelines on initial antibiotic selection are generally applied in the ICUs of Nepal and empiric choices are made for serious ICU-related infections. However, evidence suggest that patients in ICU are more prone to nosocomial infection, so antibiotics could have been used prophylactically for the prevention of infection from Staphylococcus aureus, Pseudomonas aeruginosa, Clostridioides difficile , and so on.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic utilization, sensitivity, and cost in the medical intensive care unit of a tertiary care teaching hospital in Nepal

Marasine

Shrestha

Sankhi³

et al. 2021

SAGE Open Medicine

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Background: High utilization and irrational use of antibiotics in an intensive care unit increases microbial resistance, morbidity, mortality, and costs. Objective: This study aimed to evaluate the utilization, sensitivity and cost analysis of antibiotics used in the medical intensive care unit of a tertiary care teaching hospital of Nepal. Methods: A prospective cohort study was conducted on patients admitted to the medical intensive care unit at a tertiary care teaching hospital in central Nepal from July to September 2016. Antibiotic utilization, defined daily dose per 100 bed-days and the cost of antibiotics per patient were calculated. Descriptive statistics were performed using IBM-SPSS 20.0. Results: A total of 365 antibiotics were prescribed in 157 patients during the study period, with an average of 2.34 prescriptions per patient. Total antibiotic utilization in terms of defined daily dose per 100 bed-days was 49.5. Piperacillin/tazobactam (45.2%) was the most commonly prescribed antibiotic, and meropenem was the most expensive antibiotics (US$4440.70). The median (interquartile range) cost of antibiotics used per patient was US$47.67 (US$63.73). Escherichia coli, Acinetobacter, and Pseudomonas sp. were the common organisms isolated and were found to be resistant to some of the commonly used antibiotics. Conclusion: This study suggests that the utilization and cost of antibiotics are high in medical intensive care unit of the hospital and E. coli was resistant to multiple antibiotics. The findings highlight an urgent need for the implementation of antibiotic stewardship program in order to improve antibiotic utilization in such hospital settings.

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Section: Discussionmentioning

confidence: 99%

Antibiotic utilization, sensitivity, and cost in the medical intensive care unit of a tertiary care teaching hospital in Nepal

Marasine

Shrestha

Sankhi³

et al. 2021

SAGE Open Medicine

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“…To our knowledge, this is the first report concerning TDM practices involving a range of anti-infectives in several Asian countries. Previous studies have been conducted in individual countries, have focused on specific anti-infective classes or have focused on applications in intensive care only ( Ohnuma et al, 2018 ; Choi et al, 2019 ; Hamada et al, 2020 ; Liu et al, 2021 ; Zhang et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Therapeutic drug monitoring practices of anti-infectives: An Asia-wide cross-sectional survey

et al. 2022

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Objectives: The current practice of therapeutic drug monitoring (TDM) in Asia is poorly documented. Our aim was to capture and describe TDM services delivered in hospitals across Asia, including aspects such as assay availability, interpretation of results and clinical decision-making.Methods: An online survey about anti-infective TDM practices, available in English and involving 50 questions, was promoted to people involved in TDM in Asia. The survey was open for responses from September to November 2021.Results: Of 207 responses from participants working in 14 Asian countries, 150 responses from 10 countries could be included. TDM services are available for many anti-infectives, providing assays based on chromatographic assays (100.0%) or immunoassays (39.3%). Clinicians (82.6%) and pharmacists (86.8%) were responsible for ordering and interpreting TDM. Most services provided reference targets and dose recommendations. Interpretative support was available to a varying degree. Assay results were available and clinical decision-making could be completed within 24 h in most hospitals (87.9% and 88.9% respectively). As the turnaround time of assay results decreased, the proportion of clinical decision-making completed within 8 h increased. Barriers to implementation of TDM included lack of funding or equipment (71.1%), lack of clinician interest or cooperation (47.0%), and lack of expertise (42.3%). Lack of expertise was the primary barrier for using precision dosing software (50.5%).Conclusion: There are significant differences and challenges in the development and practice of anti-infective TDM in Asian countries.

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“…A single-centre prospective study conducted in Belgium showed that among 10,731 antibiotic treatment courses recorded for 3 years, 42% (n = 4525) were prescribed for prophylaxis [13]. A nationwide, single-day survey conducted among 52 ICUs in Japan found that 34% (n = 331/1028) of the prescriptions for intravenous antibiotics written that day were for prophylaxis [14].…”

Section: Definitions and Prevalence Of "Prophylactic" Antimicrobial Tmentioning

confidence: 99%

Antibiotic prophylaxis in the ICU: to be or not to be administered for patients undergoing procedures?

2019

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

Cited by 5 publications

References 24 publications

Antibiotic utilization, sensitivity, and cost in the medical intensive care unit of a tertiary care teaching hospital in Nepal

Antibiotic utilization, sensitivity, and cost in the medical intensive care unit of a tertiary care teaching hospital in Nepal

Therapeutic drug monitoring practices of anti-infectives: An Asia-wide cross-sectional survey

Antibiotic prophylaxis in the ICU: to be or not to be administered for patients undergoing procedures?

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