Trends of Antifungal Use Based on Sales Data in Japan from 2006 to 2015.

The detailed epidemiology of invasive mycoses and superficial mycoses has not been clarified in Japan. In addition, treatment options have increased because of novel antifungals and/or guidelines for fungal infection. In the present study, we aimed to clarify the trends of antifungal use in Japan from 2006 to 2015 based on sales data to serve as an alternative indicator of fungal infection trends. We found that the total antifungal use decreased over time (r = -0.057, P _{for trend}  < 0.0001). Oral and parenteral use significantly decreased by 44.1% (r = -0.056, P _{for trend}  < 0.0001) and 27.1% (r = -0.0012, P _{for trend}  = 0.00061), respectively. The trend of antifungal use for superficial mycoses significantly decreased by 49.8% (r = -0.061, P _{for trend}  < 0.0001). However, the trend of antifungal use for invasive mycoses was significantly increased by 19.9% (r = 0.0032, P _{for trend}  = 0.00045). In Japan, the increase in the number of immunocompromised patients might be associated with the increase in the frequency of antifungal use for invasive mycoses. This is the first study to clarify the trends of antifungal use in Japan. Further research is needed to establish a continuous surveillance system to compare fungal infections between Japan and the world.