Point Prevalence Surveys of Antimicrobial Prescribing in a Non-Acute Care Hospital in Saitama Prefecture, Japan

Noriomi Ishibashi; Ines Pauwels; Yuki Tomori; Yoshiaki Gu; Takefumi Yamaguchi; Takahiro Handa; Minoru Yamaoka; Daisuke Ito; Takehiko Sakimoto; Takuma Kimura; Kouichi Takizawa; Ryota Sato; Takahiro Sakashita; Akira Ooyama; Ann Versporten; Herman Goossens; Norihito Tarumoto; Shigefumi Maesaki; Norio Tanahashi

doi:10.1155/2022/2497869

Point Prevalence Surveys of Antimicrobial Prescribing in a Non-Acute Care Hospital in Saitama Prefecture, Japan

Can J Infect Dis Med Microbiol. 2022 Mar 25:2022:2497869. doi: 10.1155/2022/2497869. eCollection 2022.

Authors

Noriomi Ishibashi^#^{1

2}, Ines Pauwels^#³, Yuki Tomori^{2

4}, Yoshiaki Gu⁵, Takefumi Yamaguchi^{2

6}, Takahiro Handa^{2

4}, Minoru Yamaoka^{2

7}, Daisuke Ito^{2

8}, Takehiko Sakimoto^{2

9}, Takuma Kimura^{2

7}, Kouichi Takizawa², Ryota Sato¹⁰, Takahiro Sakashita¹⁰, Akira Ooyama¹⁰, Ann Versporten³, Herman Goossens³, Norihito Tarumoto¹, Shigefumi Maesaki¹, Norio Tanahashi^{2

11}

Affiliations

¹ Department of Infectious Disease and Infection Control, Saitama Medical University, 38 Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan.
² Department of Internal Medicine, Maruki Memorial Medical and Social Welfare Center, 38 Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan.
³ Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Science, University of Antwerp, Universiteitsplein, Universiteitsplein 1, 2610 Wilrijk, Belgium.
⁴ Department of Gastroenterology and Hepatology, Saitama Medical University, 38 Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan.
⁵ Department of Infectious Diseases, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8510, Japan.
⁶ Department of Respiratory, Saitama Medical University, 38 Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan.
⁷ Department of General Internal Medicine, Saitama Medical University, 38 Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan.
⁸ Department of Endocrinology and Diabetes, Saitama Medical University, 38 Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan.
⁹ Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoeshi, Saitama 350-8550, Japan.
¹⁰ Department of Pharmacy, Maruki Memorial Medical and Social Welfare Center, 38 Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan.
¹¹ Department of Neurology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.

^# Contributed equally.

Abstract

Background: The global point prevalence survey (Global-PPS) is the standard for the surveillance of prescribed antimicrobials among inpatients and provides data for the development of hospital antimicrobial stewardship programs.

Aim: To evaluate the prevalence and quality of antimicrobial prescriptions using the universally standardized Global-PPS protocol in a non-acute care hospital in Saitama Prefecture, Japan.

Methods: Antimicrobial prescriptions for inpatients, staying at the hospital overnight, were surveyed on three separate week days in November 2018, January 2019, and May 2019. Information on the prescribed antimicrobials on the survey target day was obtained from the in-hospital pharmacy. Survey data were collected by physicians, based on the extracted information. Patient information was anonymized and entered in the Global-PPS Web application by physicians. We report the antimicrobial use prevalence, the indication for prescription, diagnosis, the most prescribed antimicrobials, and a set of quality indicators related to antimicrobial prescribing.

Results: In total, 6.7% of the surveyed inpatients (120/1796) were prescribed antimicrobials on the survey day. Sulfamethoxazole/trimethoprim was the most commonly prescribed, with 20.0% of systemic antibiotic prescriptions (ATC J01). Of all antibiotics for systemic use, up to 58.4% were Watch antibiotics, as defined by the World Health Organization AWaRe classification. The most prescribed group of systemic antibiotics was non-penicillin beta-lactam antibiotics (34.4%), followed by penicillin antibiotics in combination with beta-lactamase inhibitors (25.6%), and sulfonamides with trimethoprim (20.8%). Healthcare-associated infections and medical prophylaxis were the most common indications reported in 69.3% and 26.3% of prescriptions, respectively. The most common diagnosis for systemic antibiotic prescriptions was pneumonia (49.6%). Reasons for antimicrobial prescriptions were indicated in the medical records for 67.1% of prescriptions, and the stop/review date was documented to be 50.3%. Compliance with local guidelines reached 66.7%.

Conclusions: This study highlights important challenges related to antimicrobial prescription in a highly specific, non-acute care patient population.