Evaluation of the Influence of the National Action Plan on Antimicrobial Resistance and the COVID-19 Pandemic on the Consumption of Broad-Spectrum Antimicrobial and Anti-methicillin-resistant Staphylococcus aureus Agents.

Abstract

Surveillance of antimicrobial consumption (AMC) is important for controlling antimicrobial resistance (AMR). In recent years, the landscape of infectious diseases has changed due to factors such as the introduction of the National Action Plan (NAP) on AMR and the coronavirus disease 2019 (COVID-19) pandemic. However, their impact on the consumption of broad-spectrum antimicrobial and anti-methicillin-resistant Staphylococcus aureus (MRSA) agents remains unexplored. This study aimed to clarify trends in the consumption of these agents up to 2021, considering the spread of NAP and the COVID-19 pandemic. We used sales data from IQVIA Japan, which were analyzed using an interrupted time-series analysis, with April 2016 (introduction of NAP) and April 2020 (first declaration of a state of emergency) as key change points. The oral broad-spectrum antimicrobial agents consumption decreased, and the spread of the NAP (p-value: 8.15 * 10^-3, 95% confidence intervals (95% CI): -7.70 * 10^-3 to -2.06 * 10^-3) and behavioral restrictions for the COVID-19 pandemic (p value: 1.60 * 10^-8, 95% CI: -0.35 to -0.17) were significantly related to this change. Conversely, there was no notable change in the consumption of anti-MRSA agents from 2013 to 2021. Thus, the introduction of NAP and the COVID-19 pandemic may have been more effective in decreasing the consumption of oral broad-spectrum antimicrobial agents. Since antibiotics are used to treat infections across multiple anatomical therapeutic chemical classifications, continuous evaluation based on treatment purposes is important.