Trends in Outpatient Prescribing Patterns for Ocular Topical Anti-Infectives in Six Major Areas of China, 2013–2019

Abstract

Topical anti-infectives are important in the management of ocular infections, but little is known about their current status and trends in their use in China. Thus, we carried out a prescription-based, cross-sectional study using the database of Hospital Prescription Analysis Projection of China, and aimed to analyze the trend in the use of ocular topical anti-infectives for outpatients of the ophthalmology department from 2013 to 2019. A total of 2,341,719 prescriptions from 61 hospitals located in six major areas written by ophthalmologists for outpatients were identified, and 1,002,254 of the prescriptions contained at least one anti-infective. The yearly anti-infective prescriptions increased continuously from 126,828 prescriptions in 2013 to 163,434 prescriptions in 2019. The cost also increased from 4,503,711 Chinese Yuan (CNY) in 2013 to CNY 5,860,945 in 2019. However, the use rate of anti-infectives decreased slightly from 46.5% in 2013 to 41.1% in 2019. Patients aged between 19 and 45 years old had the highest anti-infective use rate. Levofloxacin was the most frequently used anti-infective and kept on increasing among all age groups, occupying 67.1% of the total cost at the end of the study. Tobramycin was more frequently used in pediatric patients than in adults, but the use still decreased. Ganciclovir was the preferred anti-viral drug over acyclovir. In conclusion, the prescriptions and cost of ocular topical anti-infectives for outpatients both increased progressively. The increasingly widespread use of levofloxacin raised concerns regarding safety in pediatrics and resistance development. The observed trends can lead to the more efficient management of ocular anti-topical anti-infectives in China.

Indication-prescription study for the management of conjunctivitis in a Colombian population

“…In the present report, a quarter of the patients were prescribed neomycin with polymyxin B and glucocorticoid; this is in contrast with other reports, in which other antibiotics predominated [7,[15][16][17][21][22][23][24]. For example, the use of polymyxin B with trimethoprim predominated in the USA (53.4%) [15], whereas it was prescribed with fusidic acid in the Netherlands (69.0%) [17], levofloxacin in China (71.8%) [21], chloramphenicol in Australia (50.8%) [16], moxifloxacin in India (52.0-53.5%) [23,24] and tobramycin in Spain (66.1%) [22] and Belgium (23.4%) [7]. The differences in drug prescription patterns have been shown in other pharmacoepidemiological studies in the country, but in different clinical contexts [25][26][27].…”

“…However, they can be used in short cycles for refractory cases of allergic and atopic conjunctivitis [8,9]. It is striking that almost 30.0% of the patients received antibiotics, which is consistent with other studies, such as those reported by De Loof et al [7] in Belgium (30.5%), and is higher than that reported by Shekhawat et al [6] in a study of more than 340,000 American patients, 20.0% of whom concomitantly used glucocorticoids and antibiotics, and by Yu et al [21] in China, where this association was present in 17.5% of cases. The use of ophthalmic glucocorticoids should be limited due to the risk of complications and adverse drug reactions, since they increase the latency period of adenoviruses, prolong the course of viral conjunctivitis, aggravate herpes simplex virus infections, increase intraocular pressure and increase the risk of glaucoma and cataracts [1,8,9,30,31] Therefore, due to the need for strict monitoring, these drug combinations should exclusively use by ophthalmologists and health personnel who have the necessary equipment to detect and prevent adverse eye reactions.…”

Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in nine major cities of China, 2016–2020: a retrospective observational study based on inpatient and outpatient hospital data

“…The patient’s several hospital admissions or visits were documented as independent of information 20. In China, this database was frequently used for pharmacoepidemiological investigations 20–23. In this study, prescription data were collected from 97 hospitals in 9 major cities of China.…”

“…20 In China, this database was frequently used for pharmacoepidemiological investigations. [20][21][22][23] In this study, prescription data were collected from 97 hospitals in 9 major cities of China.…”

Ocular Antibiotic Utilisation across Aotearoa/New Zealand

“…Little is known about ocular antibiotic utilisation across NZ. The utilisation of some ocular antibiotics has been increasing in other countries such as Spain and China [ 7 , 8 ]. Notably, rising levels of ciprofloxacin resistance in ocular isolates have been detected in NZ [ 9 ].…”