Antimicrobial utilization and antimicrobial resistance in patients with haematological malignancies in Japan: a
Wataru Mimura1, Haruhisa Fukuda2, Manabu Akazawa3
1Department of Public Health and Epidemiology, Meiji Pharmaceutical University, Kiyose, Tokyo, Japan.
Background:
Infection is a major complication for patients with haematological malignancies. It is important to better understand the use of antimicrobial agents and antibiotic resistance for appropriate treatment and prevention of drug resistance. However, very few multi-centre analyses have focused on the use of antimicrobial agents and antibiotic resistance have been carried out in Japan. This study aimed to describe the characteristics of the use of antimicrobial agents and antibiotic resistance in patients with haematological malignancies.
Methods:
We conducted a cross-sectional study using administrative claims data and antimicrobial susceptibility data in Japan. We included patients diagnosed with haematological malignancies, who were hospitalized in a haematology ward between 1 April 2015 and 30 September 2017 in 37 hospitals. Descriptive statistics were used to summarize patient characteristics, antimicrobial utilization, bacterial infections, and antibiotic resistance.
Results:
In total, 8064 patients were included. Non-Hodgkin lymphoma (50.0%) was the most common malignancy. The broad-spectrum antibiotics displayed a following antimicrobial use density (AUD): cefepime (156.7), carbapenems (104.8), and piperacillin/tazobactam (28.4). In particular, patients with lymphoid leukaemia, myeloid leukaemia, or myelodysplastic syndromes presented a higher AUD than those with Hodgkin lymphoma, non-Hodgkin lymphoma, or multiple myeloma. The most frequent bacterial species in our study cohort was Escherichia coli (9.4%), and this trend was also observed in blood specimens. Fluoroquinolone-resistant E. coli (3.6%) was the most frequently observed antibiotic-resistant strain, while other antibiotic-resistant strains were rare.
Conclusions:
Broad-spectrum antibiotics were common in patients with haematological malignancies in Japan; however, antibiotic-resistant bacteria including carbapenem-resistant or multidrug-resistant bacteria were infrequent. Our results provide nationwide, cross-sectional insight into the use of antimicrobial agents, prevalence of bacteria, and antibiotic resistance, demonstrating differences in antimicrobial utilization among different haematological diseases.
Insights
Broad-spectrum antibiotic use is common in Japanese patients with hematological malignancies, but antibiotic-resistant bacteria remain infrequent. This study offers insights into antimicrobial use and resistance patterns across different hematological diseases.
Area of Science:
- Hematology
- Infectious Diseases
- Pharmacology
Background:
- Infections are a significant complication for patients with hematological malignancies.
- Understanding antimicrobial agent use and antibiotic resistance is crucial for effective treatment and preventing drug resistance.
- Limited multi-center analyses on antimicrobial use and resistance exist for Japanese patients with hematological malignancies.
Purpose of the Study:
- To describe the characteristics of antimicrobial agent utilization in patients with hematological malignancies in Japan.
- To analyze patterns of antibiotic resistance in this patient population.
- To provide a nationwide overview of antimicrobial use and resistance.
Main Methods:
- A cross-sectional study was conducted using administrative claims and antimicrobial susceptibility data from 37 hospitals in Japan.
- Data were collected from patients diagnosed with hematological malignancies hospitalized between April 2015 and September 2017.
- Descriptive statistics were employed to analyze patient demographics, antimicrobial utilization, bacterial infections, and antibiotic resistance.
Main Results:
- The study included 8064 patients; Non-Hodgkin lymphoma was the most common malignancy (50.0%).
- High antimicrobial use density (AUD) was observed for broad-spectrum antibiotics: cefepime (156.7), carbapenems (104.8), and piperacillin/tazobactam (28.4).
- Escherichia coli was the most frequent bacterial species (9.4%), with fluoroquinolone-resistant E. coli (3.6%) being the most common resistant strain; other resistant bacteria were rare.
Conclusions:
- Broad-spectrum antibiotic use is prevalent in Japanese patients with hematological malignancies.
- Despite common broad-spectrum antibiotic use, antibiotic-resistant bacteria, including carbapenem-resistant or multidrug-resistant strains, were infrequent.
- The study provides valuable nationwide data on antimicrobial utilization, bacterial prevalence, and resistance, highlighting variations among different hematological diseases.
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