Experiences and studies on antimicrobial resistance in Japan: useful lessons for developing countries.

The use of antimicrobial drugs in Japan is remarkably high. In 1994, the total production cost of antimicrobial drugs amounted to 3.38 billion US dollars. The intensive use of broad-spectrum drugs, especially for treatment of increasing number of immunocompromised and elderly patients, resulted in the emergence and spread of antimicrobial-resistant organisms in Japan. A bacteriological study in a chronic care centre shows a variety of bacterial pathogens with increased antimicrobial resistance such as methicillin-resistant Staphylococcus aureus. Control measures of nosocomial infections with resistant organisms have been established and strengthened. This includes surveillance researches such as re-evaluation of disinfectants.