Zou Xiao-Xu, Fang Zi, Min Rui, Bai Xue, Zhang Yang, Xu Dong, Fang Peng-Qian
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
School of Foreign Languages and Literature, Wuhan University, Wuhan, 430072, China.
J Huazhong Univ Sci Technolog Med Sci. 2014 Jun;34(3):456-463. doi: 10.1007/s11596-014-1300-6. Epub 2014 Jun 18.
With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly over prescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.
随着新型抗生素数量的减少以及抗生素的不当使用，抗生素耐药性在全球医疗机构中普遍出现和传播。在中国，抗生素普遍存在过度处方和滥用的情况。本研究旨在通过调查2011年至2012年的处方信息，评估中国专科医院全国性抗生素管理专项活动对抗生素管理计划（ASP）的影响。从包括妇产医院、儿童医院、口腔医院和肿瘤医院在内的四家专科医院获取了全身性抗生素的医院消费和处方数据。采用系统随机抽样方法选择门诊处方和住院病例。对2011年的105家专科医院和2012年的121家专科医院进行了分析。每100个住院日的限定日剂量（DDD）、门诊处方中抗生素使用的百分比以及住院病例中抗生素使用的百分比被用作抗生素使用的衡量指标。在所选医院中，总体抗生素使用密度在2011年至2012年间从39.37降至26.54 DDD/100住院日（P<0.001）。两年内门诊处方中抗生素使用的百分比（范围：24.12%-18.71%，P=0.109）和住院病例中抗生素使用的百分比（64.85%-60.10%，P=0.006）也有所下降。两年内在不同地区和不同医院之间观察到了显著变化。2012年抗生素消费与专科医院的类型和规模相关，但与地区无关。对专科医院抗生素消费的这一分析允许进行相关的基准比较，并表明全国性的抗生素管理计划改善了中国抗生素的合理使用。这些数据将有助于政策制定者制定有效的策略以减少抗生素的过度使用，并确定需要进一步开展工作的领域。
