Outpatient Antibiotic Prescribing Patterns and Appropriateness for Children in Primary Healthcare Settings in Beijing City, China, 2017–2019

Haishaerjiang Wushouer,Shicai Chen,Bo Zheng,Xiaodong Guan,Luwen Shi,Kexin Du,Yue Zhou

doi:10.3390/antibiotics10101248

Abstract

(1) Background: Few studies have focused on antibiotic use and appropriateness in children in primary health institutions (PHIs). This study aimed to identify the patterns and appropriateness of antibiotic use for children in PHIs in Beijing, China. (2) Methods: Outpatient prescriptions of 327 PHIs from 2017 to 2019 for patients <18 years old were collected. Prescriptions were described using quantity indicators. Antibiotics were categorized according to ATC classification J01 and Access, Watch, Reserve grouping. Appropriateness was reviewed by experts using three subtypes of irrational prescriptions (irregular, inappropriate, and abnormal). (3) Results: 20,618 prescriptions were collected in total. The antibiotic prescription rate (APR) was 15.1% (N = 3113). Among antibiotic prescriptions, J01FA Macrolides were the most used (N = 1068, 34.9%). The Watch group constituted 89.0% (N = 2818) of total antibiotic use. Bronchitis (N = 1059, 35.2%) was the most common diagnosis. A total of 292 instances of irrational antibiotic use were identified, with inappropriate prescriptions being the most prevalent subtype (N = 233, 79.8%). (4) Conclusion: Although APR for children in PHIs in Beijing was relatively low, the pattern of antibiotic use differed from other countries. Further studies are needed to optimize antibiotic use for children in PHIs under different levels of economic development.

Highlights

The selection pressure of antibiotics, driven by inappropriate antibiotic prescribing, generates antimicrobial resistance [1,2]
To explore how antibiotics were used for children in primary healthcare institutions (PHIs), this study aims to determine the patterns and appropriateness of antibiotic prescriptions among children in PHIs in Beijing between 2017 and 2019
The antibiotic prescription rate (APR) for children demonstrated a downward trend from 17.9% (N = 995) in 2017 to 13.9% (N = 1447) in 2019

Summary

Introduction

The selection pressure of antibiotics, driven by inappropriate antibiotic prescribing, generates antimicrobial resistance [1,2]. The development of antimicrobial resistance (AMR) is further accelerated by inappropriate antibiotic use and has become a growing public health threat worldwide, for children [3,4]. Appropriate antibiotic use in children is critical, as there are limited antibiotic formulations suitable for this population. China is among the largest consumers of antibiotics worldwide and has taken many measures to strengthen antimicrobials management [6,7,8,9]. Most policies were implemented in secondary and tertiary hospitals, while primary healthcare institutions (PHIs) were subject to more localized management measures [10]. Since PHIs were not included in the national surveillance networks for both antibiotic use and AMR, understanding and addressing antibiotics use in PHIs can enhance the management of antibiotics use and AMR surveillance

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Results

Discussion

Conclusion