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Burden of Antimicrobial Resistance in Japan: A Systematic Literature Review and Meta-Analysis

Tetsuya Matsumoto1, Akira Yuasa2, Hiroyuki Matsuda3

  • 1Department of Infectious Diseases, School of Medicine, International University of Health and Welfare, Narita, Japan.

Infectious Diseases and Therapy
|April 25, 2024
PubMed
Abstract

Insights

Antimicrobial resistance (AMR) in Japan significantly increases in-hospital mortality, length of stay, and medical costs. This systematic review and meta-analysis quantifies the substantial clinical and economic burden of AMR infections.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Health Economics

Background:

  • Antimicrobial resistance (AMR) poses a significant global public health threat, with a notable impact in Japan.
  • Limited evidence exists on the specific burden of AMR within Japan.
  • This study addresses the knowledge gap by assessing the clinical and economic consequences of AMR in Japan.

Purpose of the Study:

  • To systematically review and meta-analyze existing literature on the clinical and economic burden of AMR in Japan.
  • To quantify the impact of AMR on in-hospital mortality, length of hospital stay, and direct medical costs.
  • To provide evidence for public health strategies and resource allocation in Japan.

Main Methods:

  • Conducted comprehensive literature searches across EMBASE, MEDLINE, Cochrane Library, and ICHUSHI (2012-2022).
  • Adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
  • Performed meta-analysis to estimate pooled effects (ORs for mortality, SMDs for LOS and costs) comparing AMR vs. non-AMR groups.

Main Results:

  • Included 56 observational studies (35 English, 21 Japanese); 22 studies directly compared AMR and non-AMR groups.
  • Systematic literature review indicated higher in-hospital mortality, length of stay (LOS), and direct medical costs in the AMR group.
  • Meta-analysis of 8 studies confirmed significantly higher in-hospital mortality (RE-OR 2.25), LOS (RE-SMD 0.37), and direct medical costs (RE-SMD 0.53) in patients with AMR infections.

Conclusions:

  • This study provides a comprehensive overview of the clinical and economic burden of AMR in Japan.
  • Patients with AMR infections face demonstrably higher in-hospital mortality, prolonged hospital stays, and increased direct medical costs.
  • Findings underscore the urgent need for effective AMR containment strategies in Japan.
Keywords:
AMRAntimicrobial resistanceCostJapanLOSMeta-AnalysisMortality

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