Impact of full-time equivalent allocation on the effectiveness of antimicrobial stewardship activities: A multicenter study in Okayama, Japan

Shiho Kajita; Hideharu Hagiya; Atsushi Okita; Yuto Haruki; Haruto Yamada; Yasurou Inoue; Tsukasa Higashionna; Kana Satou; Fumihiro Torigoe; Shinobu Iwamoto; Mika Yoshida; Yumiko Yamane; Hiroki Kenmotsu; Satoru Sugimura; Yutaka Fujiwara; Fusao Ikeda; Toshihiro Koyama; Chikamasa Yoshida; Shinichirou Andou; Toshimitsu Suwaki

doi:10.1016/j.jiac.2025.102730

Impact of full-time equivalent allocation on the effectiveness of antimicrobial stewardship activities: A multicenter study in Okayama, Japan

Shiho Kajita
, Hideharu Hagiya
, Atsushi Okita
, Yuto Haruki
, Haruto Yamada
, Yasurou Inoue
, Tsukasa Higashionna
, Kana Satou
, Fumihiro Torigoe
, Shinobu Iwamoto
, Mika Yoshida
, Yumiko Yamane
, Hiroki Kenmotsu
, Satoru Sugimura
, Yutaka Fujiwara
, Fusao Ikeda
, Toshihiro Koyama
, Chikamasa Yoshida
, Shinichirou Andou
, Toshimitsu Suwaki

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Background: Optimized administration of antimicrobial agents is critical for mitigating the emergence of antimicrobial resistance. This study aimed to elucidate the relationship between antimicrobial stewardship (AS) activities and antimicrobial prescription trends and patterns. Methods: This retrospective, multicenter, longitudinal study was conducted between April 2014 and March 2023 (9-year fiscal period). A structured, questionnaire survey, regarding institutional infrastructure and environmental parameters, service modalities provided by AS activities, resource allocation and systemic support, and data on the use of broad-spectrum antimicrobial agents, was distributed to co-investigators working at seven hospitals in Okayama, Japan. Full-time equivalent (FTE) allocation for each healthcare facility were calculated and subsequently compared among the hospitals. Temporal variations in the proportional distribution of broad-spectrum antimicrobial agents were statistically evaluated using joinpoint regression analysis. Results: Two hospitals where pharmacists were exclusively dedicated to AS activities and met the recommended FTE allocation showed a statistically significant reduction in the proportion of broad-spectrum antibiotic administration, with average annual percentage changes of −8.0 % (95 % confidence interval [CI]: −10.5 to −5.8) and −3.1 % (95 % CI: −5.5 to −0.7), respectively. In contrast, two other hospitals with full-time AS members but insufficient FTE allocation exhibited inconsistent and statistically nonuniform trends. The remaining three healthcare institutions with poorly resourced AS teams demonstrated no statistically significant trends in their broad-spectrum antimicrobial prescriptions. Conclusion: Our findings uncovered that hospitals with adequate FTE staffing metrics for AS activities exhibited statistically significant downward trends in the consumption of broad-spectrum antimicrobial agents.

Original language	English
Article number	102730
Journal	Journal of Infection and Chemotherapy
Volume	31
Issue number	7
DOIs	https://doi.org/10.1016/j.jiac.2025.102730
Publication status	Published - Jul 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Antimicrobial resistance
Antimicrobial stewardship
Full-time equivalent
Infection prevention and control
Trend analysis

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases
Pharmacology (medical)

Access to Document

10.1016/j.jiac.2025.102730

Cite this

Kajita, S., Hagiya, H., Okita, A., Haruki, Y., Yamada, H., Inoue, Y., Higashionna, T., Satou, K., Torigoe, F., Iwamoto, S., Yoshida, M., Yamane, Y., Kenmotsu, H., Sugimura, S., Fujiwara, Y., Ikeda, F., Koyama, T., Yoshida, C., Andou, S., & Suwaki, T. (2025). Impact of full-time equivalent allocation on the effectiveness of antimicrobial stewardship activities: A multicenter study in Okayama, Japan. Journal of Infection and Chemotherapy, 31(7), Article 102730. https://doi.org/10.1016/j.jiac.2025.102730

Kajita, S, Hagiya, H, Okita, A, Haruki, Y, Yamada, H, Inoue, Y, Higashionna, T, Satou, K, Torigoe, F, Iwamoto, S, Yoshida, M, Yamane, Y, Kenmotsu, H, Sugimura, S, Fujiwara, Y, Ikeda, F, Koyama, T, Yoshida, C, Andou, S & Suwaki, T 2025, 'Impact of full-time equivalent allocation on the effectiveness of antimicrobial stewardship activities: A multicenter study in Okayama, Japan', Journal of Infection and Chemotherapy, vol. 31, no. 7, 102730. https://doi.org/10.1016/j.jiac.2025.102730

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title = "Impact of full-time equivalent allocation on the effectiveness of antimicrobial stewardship activities: A multicenter study in Okayama, Japan",

abstract = "Background: Optimized administration of antimicrobial agents is critical for mitigating the emergence of antimicrobial resistance. This study aimed to elucidate the relationship between antimicrobial stewardship (AS) activities and antimicrobial prescription trends and patterns. Methods: This retrospective, multicenter, longitudinal study was conducted between April 2014 and March 2023 (9-year fiscal period). A structured, questionnaire survey, regarding institutional infrastructure and environmental parameters, service modalities provided by AS activities, resource allocation and systemic support, and data on the use of broad-spectrum antimicrobial agents, was distributed to co-investigators working at seven hospitals in Okayama, Japan. Full-time equivalent (FTE) allocation for each healthcare facility were calculated and subsequently compared among the hospitals. Temporal variations in the proportional distribution of broad-spectrum antimicrobial agents were statistically evaluated using joinpoint regression analysis. Results: Two hospitals where pharmacists were exclusively dedicated to AS activities and met the recommended FTE allocation showed a statistically significant reduction in the proportion of broad-spectrum antibiotic administration, with average annual percentage changes of −8.0 \% (95 \% confidence interval [CI]: −10.5 to −5.8) and −3.1 \% (95 \% CI: −5.5 to −0.7), respectively. In contrast, two other hospitals with full-time AS members but insufficient FTE allocation exhibited inconsistent and statistically nonuniform trends. The remaining three healthcare institutions with poorly resourced AS teams demonstrated no statistically significant trends in their broad-spectrum antimicrobial prescriptions. Conclusion: Our findings uncovered that hospitals with adequate FTE staffing metrics for AS activities exhibited statistically significant downward trends in the consumption of broad-spectrum antimicrobial agents.",

keywords = "Antimicrobial resistance, Antimicrobial stewardship, Full-time equivalent, Infection prevention and control, Trend analysis",

author = "Shiho Kajita and Hideharu Hagiya and Atsushi Okita and Yuto Haruki and Haruto Yamada and Yasurou Inoue and Tsukasa Higashionna and Kana Satou and Fumihiro Torigoe and Shinobu Iwamoto and Mika Yoshida and Yumiko Yamane and Hiroki Kenmotsu and Satoru Sugimura and Yutaka Fujiwara and Fusao Ikeda and Toshihiro Koyama and Chikamasa Yoshida and Shinichirou Andou and Toshimitsu Suwaki",

note = "Publisher Copyright: {\textcopyright} 2025 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control",

year = "2025",

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doi = "10.1016/j.jiac.2025.102730",

language = "English",

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T1 - Impact of full-time equivalent allocation on the effectiveness of antimicrobial stewardship activities

T2 - A multicenter study in Okayama, Japan

AU - Kajita, Shiho

AU - Hagiya, Hideharu

AU - Okita, Atsushi

AU - Haruki, Yuto

AU - Yamada, Haruto

AU - Inoue, Yasurou

AU - Higashionna, Tsukasa

AU - Satou, Kana

AU - Torigoe, Fumihiro

AU - Iwamoto, Shinobu

AU - Yoshida, Mika

AU - Yamane, Yumiko

AU - Kenmotsu, Hiroki

AU - Sugimura, Satoru

AU - Fujiwara, Yutaka

AU - Ikeda, Fusao

AU - Koyama, Toshihiro

AU - Yoshida, Chikamasa

AU - Andou, Shinichirou

AU - Suwaki, Toshimitsu

PY - 2025/7

Y1 - 2025/7

N2 - Background: Optimized administration of antimicrobial agents is critical for mitigating the emergence of antimicrobial resistance. This study aimed to elucidate the relationship between antimicrobial stewardship (AS) activities and antimicrobial prescription trends and patterns. Methods: This retrospective, multicenter, longitudinal study was conducted between April 2014 and March 2023 (9-year fiscal period). A structured, questionnaire survey, regarding institutional infrastructure and environmental parameters, service modalities provided by AS activities, resource allocation and systemic support, and data on the use of broad-spectrum antimicrobial agents, was distributed to co-investigators working at seven hospitals in Okayama, Japan. Full-time equivalent (FTE) allocation for each healthcare facility were calculated and subsequently compared among the hospitals. Temporal variations in the proportional distribution of broad-spectrum antimicrobial agents were statistically evaluated using joinpoint regression analysis. Results: Two hospitals where pharmacists were exclusively dedicated to AS activities and met the recommended FTE allocation showed a statistically significant reduction in the proportion of broad-spectrum antibiotic administration, with average annual percentage changes of −8.0 % (95 % confidence interval [CI]: −10.5 to −5.8) and −3.1 % (95 % CI: −5.5 to −0.7), respectively. In contrast, two other hospitals with full-time AS members but insufficient FTE allocation exhibited inconsistent and statistically nonuniform trends. The remaining three healthcare institutions with poorly resourced AS teams demonstrated no statistically significant trends in their broad-spectrum antimicrobial prescriptions. Conclusion: Our findings uncovered that hospitals with adequate FTE staffing metrics for AS activities exhibited statistically significant downward trends in the consumption of broad-spectrum antimicrobial agents.

AB - Background: Optimized administration of antimicrobial agents is critical for mitigating the emergence of antimicrobial resistance. This study aimed to elucidate the relationship between antimicrobial stewardship (AS) activities and antimicrobial prescription trends and patterns. Methods: This retrospective, multicenter, longitudinal study was conducted between April 2014 and March 2023 (9-year fiscal period). A structured, questionnaire survey, regarding institutional infrastructure and environmental parameters, service modalities provided by AS activities, resource allocation and systemic support, and data on the use of broad-spectrum antimicrobial agents, was distributed to co-investigators working at seven hospitals in Okayama, Japan. Full-time equivalent (FTE) allocation for each healthcare facility were calculated and subsequently compared among the hospitals. Temporal variations in the proportional distribution of broad-spectrum antimicrobial agents were statistically evaluated using joinpoint regression analysis. Results: Two hospitals where pharmacists were exclusively dedicated to AS activities and met the recommended FTE allocation showed a statistically significant reduction in the proportion of broad-spectrum antibiotic administration, with average annual percentage changes of −8.0 % (95 % confidence interval [CI]: −10.5 to −5.8) and −3.1 % (95 % CI: −5.5 to −0.7), respectively. In contrast, two other hospitals with full-time AS members but insufficient FTE allocation exhibited inconsistent and statistically nonuniform trends. The remaining three healthcare institutions with poorly resourced AS teams demonstrated no statistically significant trends in their broad-spectrum antimicrobial prescriptions. Conclusion: Our findings uncovered that hospitals with adequate FTE staffing metrics for AS activities exhibited statistically significant downward trends in the consumption of broad-spectrum antimicrobial agents.

KW - Antimicrobial resistance

KW - Antimicrobial stewardship

KW - Full-time equivalent

KW - Infection prevention and control

KW - Trend analysis

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UR - https://www.scopus.com/pages/publications/105005585816#tab=citedBy

U2 - 10.1016/j.jiac.2025.102730

DO - 10.1016/j.jiac.2025.102730

M3 - Article

C2 - 40373974

AN - SCOPUS:105005585816

SN - 1341-321X

VL - 31

JO - Journal of Infection and Chemotherapy

JF - Journal of Infection and Chemotherapy

IS - 7

M1 - 102730

ER -

Impact of full-time equivalent allocation on the effectiveness of antimicrobial stewardship activities: A multicenter study in Okayama, Japan

Abstract

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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