Initiatives to Reduce the Use of Oral Third-generation Cephalosporins and Fluoroquinolones to Help Achieve the Goals of the National Action Plan for Antimicrobial Resistance Control and Their Outcomes

The Ministry of Health, Labor and Welfare has established an action plan for antimicrobial resistance, as the spread of antimicrobial-resistant bacteria is currently an urgent problem. One of the goals included in the plan is a 33% reduction in the use of antibacterial agents by 2020, compared with that in 2013. The inappropriate use of antibacterial agents is a likely cause of the increase in antimicrobial-resistant bacteria; thus, various initiatives are being undertaken at medical institutions to emphasize the appropriate use of antibacterial agents, with a distinctive feature of the plan being the ambitious target of a 50% reduction in the use of oral cephalosporins, fluoroquinolones, and macrolide antibiotics, which are used in large quantities in Japan. Herein, various initiatives were undertaken to reduce the use of oral third-generation cephalosporins and fluoroquinolones, and the outcomes of such initiatives have been assessed, with there being few reports on similar initiatives for reducing the use of oral antibacterial agents, although initiatives aimed at limiting the use of injectable antibacterial agents have been reported. The results showed a significant reduction in the overall use of these medications as well as in the number of patients with renal dysfunction who were administered excess oral fluoroquinolones.