Evaluation of the global action plan on antimicrobial resistance in Japan during its first eighteen months

Abstract

Antimicrobial resistance (AMR) has garnered the most attention among public health concerns worldwide. Japan formulated a national action plan for AMR in April 2016. The plan seeks to reduce the amount of antimicrobials used in 2020 to two-thirds of the use recorded in 2013. Prescription surveillance (PS) is being used to monitor trends in the amount of antimicrobials used. PS estimates the number of patients prescribed an antimicrobial each day. The number of patients who were prescribed an antimicrobial under the action plan was analyzed by including dummy variables with other control variables. Data from April 1, 2011 to 30 September 30, 2017 were analyzed. When the number of patients with an infectious disease (1 of 13 specified diseases) served as a dummy variable, estimates indicated that the coefficient of that dummy variable was not significant. If the number of patients with an infectious disease (1 of 13 specified diseases) was excluded as an explanatory variable, then the estimated coefficient was significant. The global action plan in Japan might not reduce the amount of antimicrobials used. The current results indicated that the number of patients who were prescribed an antimicrobial did not decrease significantly after initiation of the action plan. This finding does not exclude the possibility that the average amount of antimicrobials used per patient has decreased.