Abstract
This study aimed to assess changes in oral antibiotic use and bacterial resistance through the antimicrobial stewardship (AS) program at an outpatient department in Fukuoka City Hospital, a medium-sized hospital. Antimicrobial use density (AUD) and days of therapy (DOT) of each antibiotic class administrated orally to outpatients in the hospital from 2011 to 2020 and resistance rates of each antibiotic in bacterial isolates from the patients were evaluated. Means of the AUD and DOT for every year and the resistance rates during the period after AS (2016-2020) were compared with those during the period before AS (2011-2015), respectively. The means of the AUD and DOT of third-generation cephalosporins, macrolides, and fluoroquinolones in the period after AS were significantly lower than those in the period before AS. The rates of levofloxacin resistance in Escherichia coli and Pseudomonas aeruginosa and erythromycin resistance in Streptococcus pneumoniae also decreased during the period after AS. AS optimized antimicrobial use, which may lead to decreased antimicrobial resistance rate in each microorganism. Several target values of the National Action Plan on Antimicrobial Resistance in Japan were achieved. These observations suggest that AS, even if it is performed in a medium-sized hospital, contributes to the proper use of antibiotics and to the reduction of detection rates of resistant organisms.
