922. Promotion of antimicrobial stewardship after issuing antimicrobial resistance national action plan in Japan: a systematic review of the literature from 2016 to 2020


 
 
 Antimicrobial resistance (AMR) is a global threat, potentially causing a significant healthcare burden. In 2016, the Japanese government issued the national action plan for AMR. Since the issuance of the Japanese AMR action plan in 2016, several ASP studies have been published in Japanese institutions. We, therefore, performed a systematic review of the literature on ASP studies conducted in Japanese institutions to elucidate the current ASP activities and understand the impact of the AMR action plan on the current state of ASPs in Japan.
 
 
 
 We searched literature based on two databases, including Medline (PubMed) and EMBASE, from January 2016 through September 2021. The risk of bias for interventional studies was assessed using ROBINS-I, and Newcastle-Ottawa Scale was used to determine the quality of cohort studies, case-control studies, and cross-sectional studies.
 
 
 
 We identified 80 studies subsequently included in the systematic review. The proportions of each type of studies were following: 30 (37.5 %) interventional studies, 15 (18.8 %) database-oriented studies, 9 (11.3 %) analytical studies (1 case-control study, 6 cohort studies, and 2 cross-sectional studies), 12 (15.0%) descriptive studies (3 cohort studies, and 9 cross-sectional study). All interventional studies were a before-after trial and interrupted time series analysis for assessing the changes in antimicrobial consumption by interventions. The subsequent targeted or overall antimicrobial use has significantly decreased (changes in a proportion ranging from 19.0 to 99.4 % in oral agents and 33.0 to 76.2 % in intravenous agents). In database-oriented studies, five studies demonstrated decreasing antimicrobial consumption after issuing AMR national action plan.
 
 
 
 The present systematic review revealed that increasing numbers of ASP studies were published after issuing the AMR action plan and showed the promotion of successful interventions of ASP studies. A few database-oriented studies showed a positive impact of AMR action plan on antimicrobial activity consumption. However, further development of high-quality studies, especially interventional studies using appropriate methodology and standardized data collection, is continuously needed.
 
 
 
 All Authors: No reported disclosures.
