2021 年 10 巻 1-2 号 p. 7-14
Introduction: Globally, the inappropriate use of antimicrobials has led to the spread of drug-resistant bacteria, which show strong resistance to first-line antimicrobials. In Japan, a high proportion of broad-spectrum antimicrobials, which are effective against many types of bacteria, are used; their use is believed to be related to the increase in the number of multidrug-resistant bacteria.
Methods: Using the Diagnosis Procedure Combination (DPC) data provided by the Ministry of Health, Labour and Welfare, this study calculated the total number of hospitalizations and the average number of days of antimicrobial use per hospitalization according to prefecture, procedure, antimicrobial component, and diabetes status.
Results: In FY27 and FY28, the total number of antimicrobials (by type) used in hospitalizations for laparoscopic cholecystectomy, open cholecystectomy, and breast malignancy surgery was 62,319, 21,296, and 42,313, respectively. Moreover, cefazolin, the only recommended Grade A-1 antimicrobial, was used in 15,914, 4,375, and 28,155 patients for laparoscopic cholecystectomy, open cholecystectomy, and breast malignancy surgery, respectively, whereas meropenem was used in 1,719, 2,161, and<10 patients, respectively.
Conclusion: Overall, the use of prophylactic antimicrobials in the perioperative period was generally in line with the recommended guidelines. However, differences in their use by region and procedure were noticeable. Future research considering the factors behind the differences in antimicrobial drug selection and using the DPC data compiled by the Ministry of Health, Labour and Welfare to monitor antimicrobial drug use is warranted.
