Secular trend analysis of antibiotic consumption in China’s hospitals 2011-2018, a retrospective analysis of sales data

Abstract

Background: This study was aimed to explore the secular trends of antibiotic consumption over an 8-year period. Methods: We retrospectively analysed aggregated monthly surveillance data on antibiotic sales to 586 hospitals from 28 provinces in China from January 2011 to December 2018. Information including generic name, sales amount, dosage form, strength, the route of administration, and geographical data were collected. Population weighted Antibiotic consumption was expressed in DDD per 1,000 inhabitants per day (DID). WHO’s ‘Access, Watch, Reserve’ categorization was also adopted to analyse antibiotic consumption. Results: Between 2011 and 2018, total antibiotic consumption in China’s hospitals increased by 38.2% (from 4.8 DID in 2010 to 6.7 DID in 2018). Antibiotic consumption was stable or had moderately decreased in 13 provinces, while the other 15 provinces had substantially increased. Cephalosporins were the most consumed antibiotics, accounted for 26.9% of the total antibiotic consumption. In 2018, antibiotics in the Access category comprised 20.0% of total consumption, where antibiotics in the Watch category consumed the most with 72.2%. Population-weighted antibiotic consumption was larger in secondary hospitals than tertiary hospitals (7.3 DID VS 6.6 DID). The antibiotics consumption of oral form was almost two times the consumption of parenteral forms in secondary hospitals, whereas the proportion of tertiary hospitals was about the same. Conclusions: Although efforts were made towards restricting antibiotics in the past decade by Chinese government, antibiotic consumption demonstrated an upward trend during the study period. More efforts are needed to explore the quality of antibiotic usage in terms of rationality.