Abstract
BackgroundChina has a high rate of antibiotic use. The Chinese Ministry of Health (MOH) established the Center for Antibacterial Surveillance (CAS) to monitor the use of antibacterial agents in hospitals in 2005. The purpose of this study was to identify trends, pattern changes and regional differences in antibiotic consumption in 151 public general tertiary hospitals across China from 2011–2014.Materials and methodsValid data for antibiotic use were collected quarterly, and the antibiotic consumption data were expressed as the defined daily dose (DDD) per 100 inpatient days (ID). We compared the patterns of antibiotic use in different classes and geographical clusters.ResultsTotal antibiotic use significantly decreased (P = 0.018) from 75.86 DDD/100 ID in 2011 to 47.03 DDD/100 ID in 2014. The total consumption of flomoxef sodium and cefminox increased from 1.31 DDD/100 BD in 2011 to 8.6 DDD/100 BD in 2014. Cephalosporins were the most frequently used antibiotics in all regions. Third-generation cephalosporins accounted for more than 45% of the cephalosporins used. Carbapenem use substantially increased (P = 0.043). Penicillin combinations with inhibitors accounted for 50% of the penicillin used, and prescribed meropenem accounted for most of the carbapenems used in all regions in 2014. The subclasses in each antibiotic group were used differently between the seven regions, and the total hospital antibiotic use in 2014 differed significantly by region (P = 0.014).ConclusionAlthough the volume and intensity of total antibiotic use decreased, the antibiotic use patterns were not optimal, and broad-spectrum antibiotics were still the main classes. The aggregate data obtained during the study period reveal similar antibiotic consumption patterns in different regions. These findings provide useful information for improving the rational use of antibiotics. More detailed data on antibiotics linked to inpatient diseases need to be collected in future studies.
Highlights
Antibiotic consumption is one of the main causes of bacterial resistance to antibiotics and is a major global public health problem[1], in China[2]
Penicillin combinations with inhibitors accounted for 50% of the penicillin used, and prescribed meropenem accounted for most of the carbapenems used in all regions in 2014
In this study, we attempted to complete the following goals: first, we aimed to investigate the trends in antibiotic consumption by inpatients in public tertiary hospitals in China after the 3-year national campaign; second, we aimed to explore the variations in the consumption and patterns of antibiotic use in different regions; and third, we aimed to analyse the evolution of frequently used antibiotics and hospital-specific antibiotics in 151 hospitals between 2011 and 2014
Summary
Antibiotic consumption is one of the main causes of bacterial resistance to antibiotics and is a major global public health problem[1], in China[2]. An increase in antibiotic consumption of up to 57% between 2000 and 2010 in the hospital sectors in Brazil, Russia, India, China and South Africa (i.e., the BRICS countries) was reported to be attributable to China[3]. Most public hospitals earn 90% of their revenue from the services they provide. China has a high rate of antibiotic use. The Chinese Ministry of Health (MOH) established the Center for Antibacterial Surveillance (CAS) to monitor the use of antibacterial agents in hospitals in 2005. The purpose of this study was to identify trends, pattern changes and regional differences in antibiotic consumption in 151 public general tertiary hospitals across China from 2011–2014
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