Reducing oral broad-spectrum antibiotics use at an outpatient setting: an antimicrobial stewardship project

Background Japan consumes a relatively high percentage of oral broad-spectrum antibiotics, especially in the outpatient setting. Therefore, Japanese national action plan was established to reduce the use of total antimicrobials and oral broad-spectrum antibiotics by 2020. We aimed to evaluate our antibiotic stewardship program in accordance with the Japanese national action plan at our ambulatory clinic. Methods First, we assessed the baseline utilization rates of both total and broad-spectrum antibiotics at our clinic from April 2018 to March 2019. After implementing interventions, we collected data from April 2019 to October 2020, and compared the data with the baseline data for evaluation of outcomes. Results Total oral antibiotic uses significantly declined by 64%, and the use of macrolides, cephalosporins, and fluoroquinolones decreased by 75%, 62%, and 45%, respectively (p < 0.001). Conclusions We successfully reduced the use of total antimicrobials and oral broad-spectrum antibiotics except fluoroquinolones in accordance with the national target.