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In recent years, antimicrobial resistance （AMR） has become a health problem worldwide. In Japan, the Ministry of Health, Labour and Welfare （MHLW） has presented an action plan for AMR countermeasures. Although the standard duration of antimicrobial therapy for dental infections has been shown to vary depending on type of infection and patient's condition, three-day therapy is considered the basic duration. Inappropriate or prolonged administration of antimicrobial agents results in the emergence of drug-resistant bacteria. Particularly, prolonged use of empiric antimicrobial agents may lead to the emergence of drug-resistant bacteria. Therefore, in this study, we evaluated the use and duration of antimicrobial administration in dental practice. The results showed that more than 80 ％ of prescriptions were for 3 days or less, with a decreasing trend in the number of prescriptions of cephalosporins, （particularly, the third-generation. In addition, there were an increasing number of prescriptions of penicillins. However, since the reduction rate of cephalosporins has not reached that reduction rate set forth in the Action Plan for AMR control, the hospital Infection Control Team （ICT） and Antimicrobial Stewardship Team （AST）, which are currently expected to carry out few interventions in dental practice, should significantly limit antimicrobial use and ensure the use of firstline drugs for treatment. The significance of these interventions in the dental field could be effective. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) are the most common bacterial infections in children. This study aimed to review characteristics of causative bacteria and the effectiveness of antimicrobial therapy in children with febrile UTIs. Methods: Clinical records of 108 patients (130 episodes) with febrile UTIs admitted to the Kawasaki Medical School Hospital between July 2009 and October 2016 were retrospectively reviewed. The characteristics of the causative bacteria, antibacterial therapy, and therapeutic effect were verified. Results: Patients were aged between 0 and 183 months (median age: 3 months). Seventy‐three (67.6%) were males. Sixty‐three episodes (48.5%) were diagnosed with complicated UTIs. Forty‐seven episodes (36.2%) were observed in patients aged <3 months; 15 of them had complicated UTIs. Escherichia coli (E. coli) was the most common pathogen, followed by Enterococcus faecalis (E. faecalis). Blood cultures were positive in three episodes. Among the 130 episodes, 62 (47.7%) were treated with a combination of ampicillin and third‐generation cephalosporins, followed by third‐generation cephalosporins (31 episodes, 23.8%) and sulbactam sodium / ampicillin sodium (15 episodes, 11.5%). In case of patients with uncomplicated/complicated UTIs and patients aged <3 and ≥3 months, the most common pathogen was E. coli, followed by E. faecalis. There was no difference in therapeutic effects between "combination ampicillin and third‐generation cephalosporins" and "third‐generation cephalosporin monotherapy" administered for the treatment of UTIs caused by E. coli. Conclusions: Escherichia coli is the most common pathogen among pediatric UTIs. For antibacterial therapy, third‐generation cephalosporin monotherapy is effective and may not require combination therapy with ampicillin. [ABSTRACT FROM AUTHOR]

• The National Action Plan on Antimicrobial Resistance significantly reduced antimicrobial use in Japan. • The plan resulted in both an immediate and accelerated reduction in antimicrobial use. • These changes were observed for total and broad-spectrum oral antimicrobials. • Parenteral antimicrobial use did not decrease after implementation of the plan. The aim of this study was to estimate the effects of Japan's National Action Plan on Antimicrobial Resistance 2016–2020 (NAP) on antimicrobial use (AMU). Monthly AMU from January 2013 to December 2019 was calculated using sales data, and time-series charts of AMU were then created for the total antimicrobials and target drug categories shown in the NAP (oral cephalosporins, oral fluoroquinolones, oral macrolides, and parenteral antimicrobials). Twelve-month predictions were generated to evaluate AMU in 2020. The publication of the NAP was associated with an AMU reduction in total antimicrobials, cephalosporins, fluoroquinolones, and macrolides. Parenteral AMU showed an upward trend, although it was not significantly associated with the intervention effect. AMU reductions of 15.0% for total antimicrobials, 26.3% for cephalosporins, 23.5% for fluoroquinolones, and 24.6% for macrolides were predicted for 2020 relative to 2013. However, there was a predicted increase of 17.4% for parenteral AMU. While Japan's NAP has contributed to the reduction in national AMU over the past 5 years, sustained action is still needed to further improve antimicrobial stewardship and promote countermeasures to antimicrobial resistance. [ABSTRACT FROM AUTHOR]

The article focuses on occupational contact urticaria syndrome from cefotiam hydrochloride. Cefotiam hydrochloride (CTM) is a cephalosporin and one of the most common parenteral antibiotics in Japan in the last 10 years. Contact urticaria is classified as an immediate type of contact reaction and is further divided into 3 etiologic groups - non-immunologic, immunologic, and unknown. Contact urticaria related to antibiotics is usually accompanied by systemic symptoms, such as hypersensitivity reaction and is thus called contact urticaria syndrome.