Pharmacist Intervention for Appropriate Use of Oral Antimicrobials in Outpatient Dental and Oral Surgeries
Considering the need to promote appropriate antibiotic use, an action plan was developed to address the problem of drug-resistant bacteria. Despite the support for appropriate antibiotic use in inpatient management, support for pharmacist-led interventions is limited in dental/oral surgery. Therefor...
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| Published in | Japanese Journal of Infection Prevention and Control Vol. 40; no. 1; pp. 8 - 12 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English Japanese |
| Published |
Japanese Society for Infection Prevention and Control
25.01.2025
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1882-532X 1883-2407 |
| DOI | 10.4058/jsei.40.8 |
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| Abstract | Considering the need to promote appropriate antibiotic use, an action plan was developed to address the problem of drug-resistant bacteria. Despite the support for appropriate antibiotic use in inpatient management, support for pharmacist-led interventions is limited in dental/oral surgery. Therefore, we aimed to clarify the effects of pharmacist-led interventions among outpatients in dental and oral surgery departments who were prescribed amoxicillin hydrate (AMPC) and cefditoren pivoxil (CDTR-PI) from October 2018 to September 2020 (preintervention group) and October 2020 to September 2022 (postintervention group), respectively, and were enrolled as study participants. We compared the average antimicrobial use density (AUD) between the preintervention and postintervention groups (AMPC: 22.2 vs. 62.7; CDTR-PI: 139.3 vs. 82.3, respectively), revealing a significant difference in CDTR-PI (p < 0.05). Despite no significant increase in the average AUD for AMPC with pharmacist-led prescription support, the use of third-generation cephalosporins significantly decreased. Thus, a pharmacist-led intervention can promote appropriate antibiotic use in outpatient settings per the current guidelines. |
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| AbstractList | Considering the need to promote appropriate antibiotic use, an action plan was developed to address the problem of drug-resistant bacteria. Despite the support for appropriate antibiotic use in inpatient management, support for pharmacist-led interventions is limited in dental/oral surgery. Therefore, we aimed to clarify the effects of pharmacist-led interventions among outpatients in dental and oral surgery departments who were prescribed amoxicillin hydrate (AMPC) and cefditoren pivoxil (CDTR-PI) from October 2018 to September 2020 (preintervention group) and October 2020 to September 2022 (postintervention group), respectively, and were enrolled as study participants. We compared the average antimicrobial use density (AUD) between the preintervention and postintervention groups (AMPC: 22.2 vs. 62.7; CDTR-PI: 139.3 vs. 82.3, respectively), revealing a significant difference in CDTR-PI (p < 0.05). Despite no significant increase in the average AUD for AMPC with pharmacist-led prescription support, the use of third-generation cephalosporins significantly decreased. Thus, a pharmacist-led intervention can promote appropriate antibiotic use in outpatient settings per the current guidelines. |
| Author | Hideki SATO Takanobu HOSHI Hiromitsu MIYAZAKI Ryosuke ENDO |
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| Cites_doi | 10.1016/j.jhin.2023.04.006 10.1371/journal.pone.0244521 10.1016/j.jiac.2023.06.014 10.5649/jjphcs.48.292 |
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| References_xml | – reference: 15) 緑川信幸, 近藤匠真, 浅倉聖岳, 奥山ひばり, 中村郁子: 歯科医師の抗菌薬投与に関するアンケート調査. 医薬品相互作用研 2019; 43: 61-6. – reference: 1) WHO's first global report on antibiotic resistance reveals serious, worldwide threat to public health: https://www.who.int/news/item/30-04-2014-who-s-first-global-report-on-antibiotic-resistance-reveals-serious-worldwide-threat-to-public-health. accessed December 11, 2023. – reference: 11) 小泉龍士, 日馬由貴, 石金正裕, 田中知佳, 大野茜子, 具 芳明, 他: 自己記入式アンケートを用いた, 歯科医師の外来診療における抗菌薬処方実態を明らかにするための横断研究. 感染症誌 2021; 95 (2): 122-8. – reference: 13) 児玉泰光, 吉田謙介, 永井孝宏, 西川 敦, 後藤早苗, 青木美栄子, 他: 歯科ICTによる外来抜歯の予防的抗菌薬適正使用支援活動. 日環境感染会誌 2020; 35 (1): 48-57. – reference: 12) 大滝康一, 濱みゆき, 高田翔和, 岩山訓典, 田﨑嘉一: アンケートを用いた市中歯科医師の薬剤耐性対策アクションプラン認知度による内服抗菌薬の使用動向と薬剤師とのかかわりに対する実態調査. 医療薬 2022; 48 (7): 292-301. – reference: 6) Hirayama K, Kanda N, Hashimoto H, Yoshimoto H, Goda K, Mitsutaka N, et al.: The five-year trends in antibiotic prescription by dentists and antibiotic prophylaxis for tooth extraction: a region-wide claims study in Japan. J Infect Chemother 2023; 29: 965-70. – reference: 2) 薬剤耐性 (AMR) 対策アクションプラン2016-2020: https://www.mhlw.go.jp/content/10900000/0000120769.pdf: 2023年12月11日現在. – reference: 10) WHO Collaborating Center for Drugs Statistics Methodology: WHO Collaborating Centres Global database: https://www.whocc.no/atc_ddd_index/. accessed December 11, 2023. – reference: 5) 薬剤耐性ワンヘルス動向調査年次報告書2022: https://amr.ncgm.go.jp/pdf/naor2022.pdf: 2023年12月11日現在. – reference: 8) 山崎勇輝, 竹野敏彦, 岩尾一生, 佐藤浩二, 髙橋浩子, 小松﨑康文, 他: 歯科医療における抗菌薬使用動向と薬剤耐性対策の現状課題. 歯薬物療 2021; 40 (1): 9-21. – reference: 4) 山本 論, 前田頼伸, 小林 睦, 寺田久仁子, 南橋 薫, 太田基博, 他: 病棟薬剤師と感染制御チームの連携による抗菌薬使用モニタリング. 日病薬誌会誌 2014; 50 (1): 37-40. – reference: 9) JAID/JSC感染症治療ガイド・ガイドライン作成委員会編, JAID/JSC感染症治療ガイド2019, 一般社団法人日本感染症学会, 東京, 2019. p. 272-4. – reference: 3) 薬剤耐性 (AMR) 対策アクションプラン2023-2027: https://www.mhlw.go.jp/content/10900000/ap_honbun.pdf: 2023年12月11日現在. – reference: 14) Okihata R, Michi Y, Sunakawa M, Tagashira Y: Pharmacist-led multi-faceted intervention in an antimicrobial stewardship programme at a dental university hospital in Japan. J Hosp Infect 2023; 136: 30-7. – reference: 7) Ono A, Ishikane M, Kusama Y, Tanaka C, Ono S, Tsuzuki S, et al.: The first national survey of antimicrobial use among dentists in Japan from 2015 to 2017 based on the national database of health insurance claims and specific health checkups of Japan. PLoS One 2020; 15: e0244521. – ident: 2 – ident: 14 doi: 10.1016/j.jhin.2023.04.006 – ident: 3 – ident: 7 doi: 10.1371/journal.pone.0244521 – ident: 5 – ident: 4 – ident: 1 – ident: 6 doi: 10.1016/j.jiac.2023.06.014 – ident: 11 – ident: 12 doi: 10.5649/jjphcs.48.292 – ident: 10 – ident: 13 – ident: 15 – ident: 9 – ident: 8 |
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| Title | Pharmacist Intervention for Appropriate Use of Oral Antimicrobials in Outpatient Dental and Oral Surgeries |
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