A nationwide questionnaire survey of clinic doctors on antimicrobial stewardship in Japan

Yoshiaki Gu; Yumiko Fujitomo; Hiroshi Soeda; Chikara Nakahama; Naoki Hasegawa; Shigefumi Maesaki; Masayuki Maeda; Tetsuya Matsumoto; Isao Miyairi; Norio Ohmagari

doi:10.1016/j.jiac.2019.12.005

A nationwide questionnaire survey of clinic doctors on antimicrobial stewardship in Japan

J Infect Chemother. 2020 Feb;26(2):149-156. doi: 10.1016/j.jiac.2019.12.005. Epub 2019 Dec 24.

Authors

Affiliations

¹ The Research Committee of the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases on Antimicrobial Stewardship in Clinics, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan. Electronic address: yogu@hosp.ncgm.go.jp.
² The Research Committee of the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases on Antimicrobial Stewardship in Clinics, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan.
³ The Research Committee of the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases on Antimicrobial Stewardship in Clinics, Japan; Department of Pharmacy, Tokyo Medical University Hospital, Tokyo, Japan.
⁴ The Research Committee of the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases on Antimicrobial Stewardship in Clinics, Japan; Nakahama Clinic, Japan.
⁵ The Research Committee of the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases on Antimicrobial Stewardship in Clinics, Japan; Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan.
⁶ The Research Committee of the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases on Antimicrobial Stewardship in Clinics, Japan; Department of Infectious Disease and Infection Control, Saitama Medical University, Saitama, Japan.
⁷ The Research Committee of the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases on Antimicrobial Stewardship in Clinics, Japan; Division of Infection Control Sciences, Department of Clinical Pharmacy, School of Pharmacy, Showa University, Tokyo, Japan.
⁸ The Research Committee of the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases on Antimicrobial Stewardship in Clinics, Japan; Department of Infectious Diseases, International University of Health and Welfare, Chiba, Japan.
⁹ The Research Committee of the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases on Antimicrobial Stewardship in Clinics, Japan; Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.

PMID: 31879188
DOI: 10.1016/j.jiac.2019.12.005

Abstract

Background: Clinics are high prescribers of antimicrobials in Japan, but the present situation and the attitude of clinic doctors toward prescribing them remain unclear.

Objective: To investigate the present situation at clinics and clinic doctors' attitude toward antimicrobial stewardship.

Study design: A questionnaire survey of clinic doctors.

Methods: A questionnaire targeting doctors was sent to 1500 clinics that were randomly selected from across the country.

Results: Among 274 respondents (response rate, 18.3%), 269 provided consent and their responses were analyzed. Awareness of the National Action Plan on Antimicrobial Resistance and the Manual of Antimicrobial Stewardship was low, but awareness of antimicrobial stewardship was high. A certain proportion of doctors prescribed antimicrobials for the common cold and acute bronchitis, and macrolides were the most commonly prescribed group of antimicrobials. Such prescription was not based solely on the doctors' knowledge but was also influenced by complex factors such as the doctor-patient relationship.

Conclusion: Various measures such as improving doctor-patient communication and improving clinic doctors' knowledge are necessary to promote antimicrobial stewardship in the outpatient setting.

Keywords: Antimicrobial stewardship; Bronchitis; Clinic; Common cold.

MeSH terms

Adult
Aged
Anti-Infective Agents / administration & dosage*
Antimicrobial Stewardship*
Bronchitis / drug therapy
Common Cold / drug therapy
Health Knowledge, Attitudes, Practice
Humans
Japan
Macrolides / administration & dosage
Middle Aged
Outpatients
Practice Patterns, Physicians'*
Surveys and Questionnaires*

Substances

Anti-Infective Agents
Macrolides