A nationwide questionnaire survey of clinic doctors on antimicrobial stewardship in Japan

Background: Clinics are high prescribers of antimicrobials in Japan, but the present situation and the attitude of clinic doctors toward prescribing them remain unclear. Objective: To investigate the present situation at clinics and clinic doctors' attitude toward antimicrobial stewardship. Study design: A questionnaire survey of clinic doctors. Methods: A questionnaire targeting doctors was sent to 1500 clinics that were randomly selected from across the country. Results: Among 274 respondents (response rate, 18.3%), 269 provided consent and their responses were analyzed. Awareness of the National Action Plan on Antimicrobial Resistance and the Manual of Antimicrobial Stewardship was low, but awareness of antimicrobial stewardship was high. A certain proportion of doctors prescribed antimicrobials for the common cold and acute bronchitis, and macrolides were the most commonly prescribed group of antimicrobials. Such prescription was not based solely on the doctors' knowledge but was also influenced by complex factors such as the doctore-patient relationship. Conclusion: Various measures such as improving doctorepatient communication and improving clinic doctors' knowledge are necessary to promote antimicrobial stewardship in the outpatient setting. (C) 2019 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.