Antibiotic use in Chinese hospitals: a multicenter point-prevalence study

Xie, Daxing; Xiang, Lili; Hu, Qing; Fu, Xiang-yun; Wang, H.F.; Lai, Rui-ping; Han, Yong; Li, R.; Luo, Q.Q.; Xiong, Wei

doi:10.1016/j.puhe.2015.02.010

Cited by 9 publications

(6 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of antimicrobial consumption at YGH (64.4%) was similar to surveys conducted in hospitals in Kenya, Botswana, and from west and central Asian countries that reported antimicrobial use prevalences of 67.7%, 70.6%, and 69.1%, respectively [ [21] , [22] , [23] ]. However, the prevalence of antimicrobial use at YGH was higher than that reported from hospitals in North America (38.6%–50.0%), Turkey (30.6%), and Scotland (28.3%) [ 12 , [23] , [24] , [25] , [26] , [27] ]. The higher prevalence of antimicrobial prescribing observed in our surveys, and surveys in other hospitals in LMICs, compared to these high-income countries may reflect a higher burden of infectious diseases, more severe illnesses, or less restrictive antimicrobial prescribing policies [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 68%

Point-prevalence surveys of antimicrobial consumption and resistance at a paediatric and an adult tertiary referral hospital in Yangon, Myanmar

Carr

Marchello

et al. 2022

Infection Prevention in Practice

View full text Add to dashboard Cite

Summary Background Antimicrobial resistance is increasingly prevalent worldwide. The inappropriate use of antimicrobials, including in the hospital setting, is considered a major driver of antimicrobial resistance. Aim To inform improvements in antimicrobial stewardship, we undertook point prevalence surveys of antimicrobial prescribing at Yangon Children's Hospital and Yangon General Hospital in Yangon, Myanmar. Methods We conducted our surveys using the Global Point-Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) method. All inpatients who were prescribed an antimicrobial on the day of the survey were included in the analysis. Findings We evaluated a total of 1,980 patients admitted to two hospitals during December 2019. Of these, 1,255 (63.4%) patients were prescribed a total of 2,108 antimicrobials. Among antimicrobials prescribed, 722 (34.3%) were third-generation cephalosporins, the most commonly prescribed antimicrobial class. A total of 940 (44.6%) antimicrobials were prescribed for community-acquired infection, and 724 (34.3%) for surgical prophylaxis. Of 2,108 antimicrobials, 317 (15.0%) were prescribed for gastrointestinal tract prophylaxis, 305 (14.5%) for skin, soft tissue, bone and joint prophylaxis, and 303 (14.4%) for pneumonia treatment. A stop or review date was documented for 350 (16.6%) antimicrobial prescriptions, 673 (31.9%) antimicrobial prescriptions were guideline compliant, and 1,335 (63.3%) antimicrobials were administered via the parenteral route. Of 1,083 antimicrobials prescribed for a therapeutic use, 221 (20.4%) were targeted therapy. Conclusion Our findings underscore the need to update and expand evidence-based guidelines for antimicrobial use, promote the benefits of targeted antimicrobial therapy, and support the implementation of hospital-based antimicrobial stewardship programmes at the hospitals surveyed.

show abstract

Section: Discussionmentioning

confidence: 68%

Point-prevalence surveys of antimicrobial consumption and resistance at a paediatric and an adult tertiary referral hospital in Yangon, Myanmar

Carr

Marchello

et al. 2022

Infection Prevention in Practice

View full text Add to dashboard Cite

show abstract

“…[ 14 ] It was also lower than that reported in another study in Hubei Province. [ 15 ] However, compared with the proportion in the United States[ 16 ] and some European countries,[ 17 ] such as Sweden, where antibiotic prescriptions represent 1.1% of all prescriptions,[ 14 ] the proportion remains high in Beijing tertiary hospitals. In primary general hospitals, the proportion in Beijing was also lower than that in other provinces, such as Jilin and Jiangsu Province.…”

Section: Discussionmentioning

confidence: 99%

“…A study showed that almost 30% of all antibiotic prescriptions were for antibiotic combinations in tertiary hospitals in Hubei Province. [ 15 ] The proportion in Beijing was significantly lower than that in Hubei Province. Antibiotic combinations were prescribed for serious diseases or patients who were infected by multiple microorganisms to provide broad-spectrum antibacterial efficacy.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Outpatient Antibiotic Use in Beijing General Hospitals in 2015

Yang

Cai

Zhou

2017

Chinese Medical Journal

View full text Add to dashboard Cite

Background:Medical misuse of antibiotics is associated with the acquisition and spread of antibiotic resistance, resulting in a lack of effective drugs and increased health-care cost. Nevertheless, inappropriate antibiotic use in China remains common and the situation requires urgent improvement. Here, we analyzed the prescriptions of antibiotics and evaluated the rationality of antibiotic use among outpatients in Beijing general hospitals during 2015.Methods:We collected basic medical insurance claim data from January 1, 2015 to December 31, 2015 in 507 general hospitals of Beijing. A descriptive analysis of outpatient antibiotic prescribing was performed. The Anatomical Therapeutic Chemical Classification/defined daily doses system was used to evaluate the rationality of antibiotic use.Results:Over the study, an estimated 721,930, 613,520, and 822,480 antibiotics were dispensed in primary, secondary, and tertiary general hospitals corresponding to 5.09%, 5.06%, and 2.53% of all prescriptions, respectively. Antibiotic combinations represented 2.95%, 7.74%, and 10.18% of the total antibiotic prescriptions, respectively. Expenditure for the top twenty antibiotics in primary, secondary, and tertiary general hospitals was RMB 42.92, 65.89, and 83.26 million Yuan, respectively. Cephalosporins were the most frequently prescribed class of antibiotic in clinical practice. The antibiotics used inappropriately included azithromycin enteric-coated capsules, compound cefaclor tablets and nifuratel nysfungin vaginal soft capsules in primary hospitals, amoxicillin and clavulanate potassium dispersible tablets (7:1) and cefonicid sodium for injection in secondary hospitals, cefminox sodium for injection and amoxicillin sodium and sulbactam sodium for injection in tertiary hospitals.Conclusions:Antibiotic use in Beijing general hospitals is generally low; however, inappropriate antibiotic use still exists. Inappropriately used antibiotics should be subject to rigorous control and management, and public policy initiatives are required to promote the judicious use of antibiotics.

show abstract

“…To solve this problem, the Ministry of Public Health of China organised a special examination for the rational use of antibiotics and standardised the use of antibiotics at all levels of hospitals. Remarkable results have been achieved 5 6. At present, the focus is on how to establish a long-term scientific and specialised management mechanism for antibiotics, prevent rebound, optimise an anti-infection treatment scheme and improve the level of drug treatment.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the impact of antimicrobial management and rational use of antibiotics

et al. 2019

View full text Add to dashboard Cite

ObjectiveThe scientific antimicrobial management strategy (AMS) was used to standardise the clinical use of antibiotics and optimise the anti-infection treatment protocol.MethodsBy formulating antibiotic use indicators and policy interventions, carrying out prescription audits and drug analysis by pharmacists, and establishing an early warning mechanism for bacterial drug resistance, we formed a long-term and scientific antimicrobial management strategy.ResultsFrom 2012 to 2017, the clinical antibiotics use indicators appeared to trend downward. The rate of antibiotic use in outpatients, the rate of antibiotic use in hospitalised patients, and the antimicrobial use density decreased by 40.36%, 20.93%, and 10.71%, respectively, and the per capita drug cost of antibiotics in outpatients and inpatients decreased. The microbiological susceptibility test rate of antibiotics in hospitalised patients increased each year, and the resistance rate of the main detected bacteria did not significantly increase in the last 6 years. In the evaluation of rational drug use, the use of antibiotics has become more reasonable and standardised, and irrational drug use has been significantly reduced, but we still need to strengthen the optimisation of treatment prescription.ConclusionsScientific management can promote the rational use of antibiotics, reduce the expense of drug use and slow the development of drug resistance, but we need to further optimise the prescription of antibiotics to improve the level of drug treatment.

show abstract

Antibiotic use in Chinese hospitals: a multicenter point-prevalence study

Cited by 9 publications

References 9 publications

Point-prevalence surveys of antimicrobial consumption and resistance at a paediatric and an adult tertiary referral hospital in Yangon, Myanmar

Point-prevalence surveys of antimicrobial consumption and resistance at a paediatric and an adult tertiary referral hospital in Yangon, Myanmar

Evaluation of Outpatient Antibiotic Use in Beijing General Hospitals in 2015

Analysis of the impact of antimicrobial management and rational use of antibiotics

Contact Info

Product

Resources

About