Advanced neonatal medicine in China: Is newborn ward capacity associated with inpatient antibiotic usage?

Abstract

Previous surveys of neonatal medicine in China have not collected comprehensive information on antibiotic use in newborns. The goal of the present study was to assess the trends in antibiotic use in inpatient newborns from advanced hospitals in mainland China and to evaluate the contributing factors. We extracted retrospective data on newborn clinical units from a database containing key clinical subspecialty area indicators from provincial or ministerial (Class A level III) hospitals over three consecutive years (2008–2010) and in 25 of 31 provincial districts of mainland China. Fifty-five newborn units were included in the study. The results showed that two thirds (65.7% ± 23.1%) of inpatient newborns were prescribed antibiotic products. Antibiotic use rates were significantly different by newborn ward bed capacity ( p = 0.023; 60.6% for d capacity (ficant65.7% ± 23–100 beds group, and 77.1% for (ficant65.7% ± 23.1%) of inpatient newb significantly different by type of hospital, geographic area, admission to physician or nurse ratio, or physician or nurse academic degree. Factors contributing significantly to antibiotic use included ward bed capacity, physician to nurse ratio, average hospital stay, and pneumonia to preterm infant ratio. Our data suggested that the use of antibiotics among inpatient newborns in advanced hospitals in mainland China was prevalent and should be subject to rigorous monitoring, and highlighted the need to explore how newborn ward bed capacity potentially impacts antibiotic use.

Mortality and Morbidity of Infants Born Extremely Preterm at Tertiary Medical Centers in China From 2010 to 2019

“…Regional disparities in the resources of neonatal medicine, such as experienced professionals and advanced equipment, may be associated with clear differences in outcomes. 36 Additionally, such regional variations may be ascribed to different care practices among units and regions owing to a lack of consensus on clinical practices; for example, we found a divergence in use of active treatments, prenatal corticosteroids, 37 antibiotics, 38 and human milk feeding. 39 …”

Prevalence and risk factors for antibiotic utilization in Chinese children

“…It was reported that individuals in most rural areas continue to have easy access to antibiotics [ 125 ]. The rate of antibiotic use was also associated with bed capacity, newborn units with more than 100 beds had the highest rate of antibiotic use, compared to units with 50 or fewer beds, and those with 51–100 beds [ 124 ].…”

Initial respiratory support modality and outcome in preterm infants with less than 32 weeks of gestation in China: A multicentre retrospective cohort study

“…China is a middle‐income country with a large population density, while the low proportion of medical staff per capita is a real issue in the country. The number of physicians, number of nurses, nurse to bed ratio, physician to nurse ratio, proportion of physician with graduate degree and proportion of nurses with at minimum a college certificate is significantly inadequate, in China 14 . Accordingly, there are some practical difficulties in the implementation of European or American guidelines for the management of RDS in China, and large sample and multicentre studies on the relationship between initial respiratory support pattern and prognosis are rare in China.…”