Changes of the Bacterial Resistance from Uncomplicated Cystitis in Japan

Shingo YamamotoJapan Speaker Changes of the Bacterial Resistance from Uncomplicated Cystitis in JapanThe spread of antimicrobial resistance (AMR) is an increasing threat to all of humanity. Southeast and South Asian countries are among the world's leading AMR-endemic countries, with advanced AMR spreading through various international routes. Considering the mass administration of antibiotics to livestock and pets, and the spread of antibiotics and drug-resistant bacteria in the environment, measures to combat AMR cannot be completed within the human medical field alone. It is necessary to clarify the concept of the One Health approach and for various sectors, including human medical fields (such as veterinary medicine and the environment), to work together toward the same goal. When Japan's infectious disease control guidelines were published in 2011, fluoroquinolones were positioned as the first-choice drug for the treatment of acute uncomplicated cystitis in both pre- and postmenopausal women, because they are highly effective against both gram-negative and gram-positive bacteria. However, quinolone-resistant and ESBL-producing strains of Gram-negative bacteria, mainly E. coli, are increasing year by year, and many ESBL-producing strains are quinolone-resistant. Therefore, it is considered that the use of cephalosporins and quinolones should be severely restricted, and it is necessary to discuss the important issue of appropriate use of antibiotics.