歯科における抗菌薬の使用傾向―私立歯科大学附属17病院における使用実態調査―

抄録

The present study surveyed the application of antimicrobials in dental practice in 17 private dental college or university hospitals in Japan, in order to investigate the actual conditions of using antimicrobials.
According to the medicinal virtues, a drug list with percentage was prepared depending upon the number of actual use of internal medicine, injections provided in the prescription or instructions for the 10-day period from September 4 to 15, 2006. Furthermore, a survey of the kind of antimicrobials with consumption for each hospital was also done for the six-month period from April 1, 2006 to September 30, 2006.
Classified by medicinal virtues by internal use medicines, the proportion of antibacterial and anti-inflammatory analgesic drugs accounted for 32% each, and gargle and gastrointestinal medicine for 12% and 10% respectively. Among the internal use antimicrobials, usage of the cephem system was 54% whereas penicillin and macrolide system were 23% and 21%, respectively. The largest consumption was cefcapene pivoxil hydrochloride for antibacterial medicines. This drug was widely used in 10 out of 17 hospitals. Erythromycin ethylsuccinate was in second position, followed by cefdinir, rifampicin and ampicillin.
The method of marking order of each hospital and order of the total consumption were analyzed and some differences in consumption of different drugs were observed. Many hospitals suggested the use of clarithromycin, cefaclor and amoxicillin although consumption was low.
According to the medicinal virtues of injectable medicines, the frequency of use of antimicrobials was the highest (34%) . Among the injectable antimicrobials, the cephem based system (60%) and penicillin system (33%) accounted for more than 90% of the total use. Cefazolin was the most consumed drug, followed by asoxicillin, flomoxef sodium and ceftriaxone.