Tao Jianhong, Zhang Tiantian, Xu Jun, Wu Chuanbin
1 School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, China.
2 Southern Medicine Economic Institute, State Food and Drug Administration, Guangzhou, China.
Ther Innov Regul Sci. 2013 Jan;47(1):23-31. doi: 10.1177/0092861512466397.
To investigate the present situation of antibiotics use in selected hospitals in China according to 2 indicators: hospital-based market sales and frequency of usage; based on this information, to assess the government's containment policies toward antibiotics overuse.
Marketing and clinical usage data of antibiotics in 420 selected hospitals from 21 major cities and 1 district in China during 2008-2011 were collected and analyzed. Usage frequency was measured by the defined daily dose (DDD) analytic approaches recommended by World Health Organization (WHO), and the growth rate of DDDs per patient was compared for 3 categories of antibiotics: nonlimited (first line), limited (second line), and specially controlled (third line).
During the period studied, an obvious slowdown was observed in both sales value and the growth of sales volume for the 3 categories. With respect to frequency, both limited-level and specially controlled level antibiotics with high cost and low safety and effectiveness showed an evident decline in the growth rate of DDDs per patient ( P < .05). However, no significant decline was found for nonlimited antibiotics ( P > .05).
The Chinese government's containment policies toward antibiotics overuse are beginning to take effect, and antibiotics usage has become more measured in major cities. However, China still has a long way to go before it can win the battle against antibiotics overuse and drug resistance.
根据两项指标调查中国部分医院抗生素使用现状:医院市场销售额和使用频率;基于这些信息,评估政府针对抗生素过度使用的遏制政策。
收集并分析2008 - 2011年期间中国21个主要城市和1个地区420家选定医院抗生素的销售和临床使用数据。使用频率采用世界卫生组织(WHO)推荐的限定日剂量(DDD)分析方法进行测量,并比较了三类抗生素的人均DDD增长率:非限制类(一线)、限制类(二线)和特殊管控类(三线)。
在研究期间,这三类抗生素的销售额和销售量增长均明显放缓。在使用频率方面,成本高且安全性和有效性低的限制级和特殊管控级抗生素人均DDD增长率均显著下降(P < 0.05)。然而,非限制类抗生素未发现显著下降(P > 0.05)。
中国政府针对抗生素过度使用的遏制政策已开始生效,大城市的抗生素使用已更加审慎。然而,在赢得抗生素过度使用和耐药性斗争之前,中国仍有很长的路要走。