抗菌薬使用量集計マニュアル - amr.ncgm.go.jp

1 Ver 2018 11 .. 2016 4 AMR . 2015 WHO .. AMR 6 .. AMR .. infection control team: ICT antimicrobial stewardship team: AST .. 1.. 1. 1 .. 3. 2 AUD .. 6. Q2-1.. 6. Q2-2. AUD .. 8. Q2-3. AUD .. 15. Q2-4. AUD .. 16. 3 DOT .. 18. Q3-1.. 18. Q3-2. DOT .. 20. Q3-3. DOT .. 27. Q3-4. DOTs .. 28. 4 AUD DOT .. 29. Q4-1. AUD DOT .. 29. Q4-2. AUD/DOT .. 31. DDD .. 38.. 41.. 42.. 44. 2. 1 . antimicrobial resistance AMR . AMR antimicrobial . resistance . AMR AMR .. antimicrobial usage . AMU . AMU antimicrobial usage .. AMR .. 24 .. AMR .. 3. 1 1 . g .. antimicrobial use density AUD . days of therapy DOT AUD antimicrobial use density .. DOT days of . therapy .. AUD .. AUD . Q2-1, 2- . 2, 2-3, 2-4 . DOT .. DOT . AUD 1 . DOT . Q3-1, 3-2, 3-3, 3-4.. 4.. MRSA .. 5. 2 AUD . Q2-1.. AUD antimicrobial use density .. DPC diagnosis procedure combination .. DPC DPC EF .. 1 EF .. E . F .. EF.

2 6. 1 AUD .. AUD . DPC . 4 .. DPC .. EF DPC AUD .. DWH: .. 7. Q2-2. AUD . AUD antimicrobial use density . AUD . g . DDD DDD defined daily dose . 1 . g (bed-days) 3 .. AUD (DDDs / 100 bed-days). DDDs . (g) / DDD (g) g . = 100 /DDD(g) .. (bed-days) DDD .. Point . 1000 . g .. g .. AUD .. g .. DDDs/100bed-days .. DDD (g). DDD defined daily dose WHO . 1 . DDD .. 70 kg . DDD .. 8. DDD WHO . DDD . DDD 40 . bed-days . AUD .. 24 . 24 .. AUD . 100 1000 .. 100 1000 .. 9. ATC DDD . ATC anatomical therapeutic chemical classification system . ATC WHO .. ATC . ATC . DDD defined daily dose . DDD WHO 70kg . 1 AUD. DDD . 100 1000 . Q2-2 DDD . AUD 1 .. AUD .. DDD . 3 5 . ATC DDD WHO Collaborating Centre for Drug Statistics Methodology WHOCC .. 10. AUD .. 2 .. 2018 1 AA . 1 4V 1 .. 2017 12 30 2018 1 31 .. 10V 2V. 1g 65V 49V. 500mg 20 26 . 11.. Excel g .. 12.. g . g g . g Q2-4 .. DDD.

3 DDD 2 g, g, g .. 500 . 13. AUD . AUD (DDDs/ 100 bed-days). /DDD / 100. AUD . 14. Q2-3. AUD . (DDD = 2 g) DDDs/100 bed-days . 100 1 2 g 3 .. AUD .. DDD 70kg . AUD . AUD .. 15. Q2-4. AUD . DDD AUD .. / .. / g 10 . g g g 10 . 10 g / g . 10 g 10 5 g . ST. / . DDD unit dose UD . ST 1 1UD .. 16. 2 .. / 2 1 . 1g / 8 1 . 4g / 1 1 1g .. / 1 1 / 1 1 . 1. / 1 1 1000mg 1UD. 1UD= . 500mg/ . 500mg . 1. / 5 1 1 1UD. 1UD= . 400mg/ . 80mg . 1 1 1 1UD . 1UD . 17. 3 DOT . Q3-1.. 3 EF .. DOT AUD . bed-days . 24 .. 24 .. 18. 3 DOT .. DOT . DPC . 4 .. DPC .. EF DPC DOT .. DWH: .. 19. Q3-2. DOT . DOT days of therapy . DOT days of therapy .. DOT .. A 1 1 g, 1 1 . 2 2 DOTs DOTs . B 1 1 g, 1 3 .. 2 2 DOTs 2 DOTs AUD . DOT . bed- days .. DOT Centers for Disease Control and Prevention; CDC .. DOT (DOTs/100bed-days).. 100. bed-days . AUD DDD . 1 . DOT 1 .. AUD DOT .. 20. DOT 100 1000 .. 100 1000.

4 21. DOT .. 22. 2018 1 . 2018 1 DOT .. 2018 1 15 -2018 1 20 2018 1 15 -2018 1 16 . 6 2 . 23.. 2017 12 29 -2018 1 3 2018 1 10 -2018 1 23 . 6 14 .. 2018 1 10 -2018 1 16 2018 1 29 -2018 2 6 . 7 9 . 24. 1 DOT 2017. 12 2018 2 . 6 . 1g 2 . 500mg 17 . 1 1 3 3 1 10 23 14 17 . 1g 7 . 1g 3 . 1 29 31 3 . 1g 12 .. 500 . 25. DOT . DOT (DOTs/100 bed-days) / 100. DOT . 26. Q3-3. DOT . DOT . DOT (DOTs/100 bed-days) . 100 3 . 1 3 3 1 . DOT 1 . ICU .. 27. Q3-4. DOTs .. A 1 1 g 1 3 4 1 4 4 4 . 1 600 mg 1 3 4 3 4 7 5 .. 4 DOTs 5 DOTs 9 DOTs B 1 1 g 48 4 1 4 5 . 4 1 3 5 3 3 DOTs LOT (length of therapy). 1 LOT. length of therapy .. A 4 1 7 7 LOTs . 28. 4 AUD DOT . Q4-1. AUD DOT . AUD DOT . AST antimicrobial stewardship team . AUD DOT . AUD . DOT . 4 . AUD DOT . AUD DOT . AUD DOT .. AUD DOT .. 29. 4 AUD DOT .. AUD DDD .. WHO DDD .. DOT WHO DDD .. AST ASP . AST: antimicrobial stewardship team.

5 ASP: antimicrobial stewardship program .. 30. Q4-2. AUD/DOT . AUD DOT . AUD DOT AUD/DOT . AUD DOT .. 1 1 AUD . 1 . AUD AUD/DOT . 1 AUD/DOT .. AUD/DOT AUD/DOT .. AUD. AUD/DOT=. DOT. AUD DOT . 31. AUD/DOT Q2-2 AUD Q3-2. DOT 2018 3 . AST . A) 2018 1 -6 . AUD. AUD DDDs/100bed-days . 1.. 0. 1 2 3 4 5 6 . DOT. DOT(DOTs/100bed-days). 1.. 0. 1 2 3 4 5 6 . 32. AUD/DOT.. AUD/DOT. 1.. 0. 1 2 3 4 5 6 . AUD . DOT AUD/DOT . 1 1 . 1 AST .. 33. B) 1g 2018 1 -6 . AUD.. AUD DDDs/100bed-days . 2. 1.. 0. 1 2 3 4 5 6 . DOT. 3 . DOT(DOTs/100bed-days). 2. 1.. 0. 1 2 3 4 5 6 . 34. AUD/DOT. 1. AUD/DOT.. 0. 1 2 3 4 5 6 . AUD DOT . AUD/DOT 1 .. AST .. 35. C) 500mg 2018 1 -6 . AUD. AUD DDDs/100bed-days . 2.. 1.. 0. 1 2 3 4 5 6 . DOT. 4. DOT(DOTs/100bed-days). 3. 2.. 1 . 0. 1 2 3 4 5 6 . 36. AUD/DOT. 1. AUD/DOT.. 0. 1 2 3 4 5 6 . AUD DOT AUD/DOT 1 .. AST .. AUD DOT AUD/DOT . ASP .. 37.. DDD.

6 DDD .. Ver 2019 1 . DDD.. 4. 1. 6. 2UD. 1).. 6.. 2.. 1. 1. 3.. 2) 1. 3. 4UD. 38. 3. 4. 4. 4. 4. 4. 4.. 4. 4. 2. 4. 4. 4. 2. 1. 2. 2.. 14. 14.. 2. 3) . 8. 39.. 3. 4. 4) .. DDD.. 1. 1 UD . 1UD 500 mg+ 500 mg DDD 2UD.. 2 DDD WHOCC 900 150 mg 450 . DDD g . 3 100 g . 4 WHOCC DDD g .. 40.. 2016 .. Muraki Y, et al. Japanese antimicrobial consumption surveillance: First report on oral and parenteral antimicrobial consumption in Japan (2009-2013). J Glob Antimicrob Resist. 2016 Aug 6;7:19-23. doi: PMID: 27973324. Yamasaki D, et al. The first report of Japanese antimicrobial use measured by national database based on health insurance claims data (2011-2013): comparison with sales data, and trend analysis stratified by antimicrobial category and age group. Infection. 2018 Apr;46(2):207-214. doi: Epub 2017 Dec 22. PMID: 29273972. Tsutsui A, et al. Trends and patterns of national antimicrobial consumption in Japan from 2004 to 2016.

7 J Infect Chemother. 2018 Feb 7. pii: S1341-321X(18)30008-4. doi: PMID: 29428566.. WHO Collaborating Centre for Drug Statistics Methodology ( ). AMR 2006-2020 Seisakujouhou-10900000- . AMR .. AMR . Web .. European Surveillance of Antimicrobial Consumption Network (ESAC-Net). networks/esac-net . 41.. 2016 4 5 AMR . AMR . 2017 7 .. 2018 11 9 .. 2018 6 .. 2018 3 .. 2018 6 .. AMR) .. 8 . 2018 4 .. 8 .. 8 .. 8 . 42. 8 .. TDM .. AMR .. AMR .. 43.. Ver 2019 1 . 2019 1 WHO Collaborating Centre for Drug Statistics Methodology . DDD defined daily dose 1 p 38-41. DDD .. 2g 6g 2g 4g 2g 3g 44.