Article ID: JJID.2019.476
Antimicrobial resistance (AMR) is an emerging problem in both acute care hospitals and nursing homes. From January to December 2016, we conducted a pilot, descriptive epidemiological study to examine antimicrobial use (AMU) among six nursing homes in Tokyo, Japan. AMU was extracted from prescription data of a pharmacy that received all prescriptions from the nursing homes. To standardize the comparison of drug usage, AMU was measured using defined daily dose (DDD) and described as DDDs/1,000 resident-days. The overall AMU was 15.3/1,000 resident-days including oral-antimicrobials (15.2/1,000 resident-days [99.3%]). The most frequently prescribed oral-antimicrobials was macrolides (5.8/1,000 resident-days [38.2%]) and quinolones (4.2/1,000 resident-days [27.6%]). Oral-macrolides and quinolones were thought to be convenience in prescription among nursing homes with resource limiting due to smaller defined the number of daily doses compared to penicillins and cephalosporins. Further multi-center studies that include residents-specific data (demographics and diagnosis), and focusing on purpose of antimicrobials (treatment or prevention) are needed to evaluate the appropriateness of antimicrobials.