歯科における抗菌薬の使用動向

─私立歯科大学附属18病院における使用実態調査─

抄録

The purpose of the present study was to survey the use of antibacterial agents at 18 private dental college or university hospitals in Japan, as performed approximately every 10 years since 1983, and to identify the diseases treated with these medicines for longer than eight days at these dental hospitals. We first calculated the amount of antibacterial agents prescribed in October 2013. For internal and external preparations, almost all antibiotics comprised cephems （68％, 64％）, penicillins （23％, 25％） and macrolides （7％, 8％）, with values expressed in terms of percentage for outpatient and inpatient treatments, respectively, and these values were similar to previous surveys. The ratio of internal and external preparations was nearly six-fold higher when compared with injections. About 70％ of oral cephems administrated to both outpatients and inpatients was cefcapene pivoxil hydrochloride. In contrast, the antibacterial injection administered to inpatients was primarily cefazolin sodium and that to outpatients was primarily ceftriaxone sodium hydrate. The ratio of carbapenems was less than 1％. Among the antibacterial agents administered for longer than eight days, clarithromycin was mainly used for the treatment of odontogenic chronic sinusitis. Our study suggested that clarithromycin was used appropriately in long-term treatment for chronic diseases. However, we found that a limited variety of oral cephems were heavily used for short-time administration, which might lead to the emergence of resistant bacteria. Pharmacist information and advice may be helpful for dentists to avoid it because proper pharmaceutical management of antibacterial agents is essential for the prevention of resistant bacteria.