Trends and Drivers of Inpatient Antibiotic Consumption among 89 China Tertiary General Hospitals from 2011Q1 to 2015Q4.

Jiangyun Chen,He Wang,Rui Min,Haomiao Li,Pengqian Fang,Shengwen Zhao

doi:10.1155/2018/5968653

Jiangyun Chen, He Wang + Show 4 more

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https://doi.org/10.1155/2018/5968653

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Abstract

Antibacterial surveillance is an essential measure for strengthening the management of clinical antibiotic use. This study aimed to determine the trends and drivers of inpatient antibiotic consumption in China. A sample of 89 hospitals with complete data from 2011Q1 to 2015Q4 was included. Accumulative defined daily doses (DDDs), antibiotic use density (AUD), and drug variety were calculated to evaluate antibiotic consumption. From 2011Q1 to 2015Q4, the median values of DDDs, AUD, and drug variety dropped by 10.49%, 39.19%, and 27.96%, respectively. Panel regression results showed, for each additional quarter, DDDs reduced by 6.714 DDDs, AUD reduced by 0.013 DDDs per 100 inpatients per day, and drug variety reduced by 0.012 types (p < 0.001). National hospitals were more likely to use antibiotics, with the highest number of DDDs (106 709 DDDs) and AUD (60 DDDs per 100 inpatients per day) and a large number of drug variety (71 types of drug) all reported from national hospitals. Overall, a downward trend of inpatient antibiotic consumption was observed in competitive tertiary general hospitals in China. However, antibiotic use in China, especially in national hospitals, continues to exceed the guidelines set forth by the nationwide antibiotic stewardship program. China must continue to improve surveillance of antibiotic consumption by constructing a more comprehensive, continuous, and targeted stewardship program. Policy interventions in China should be made in consideration of unbalanced regional development and the consequences this may have on antibiotic consumption.

Highlights

With dwindling numbers of new antibiotics being developed and widespread inappropriate use of current antibiotics, antibiotic resistance has emerged as a common and growing issue in healthcare institutions worldwide [1]
defined daily doses (DDDs), antibiotic use density (AUD), and drug variety were complex in regional distribution
The data showed that national hospitals were likely to use more antibiotics, with national hospitals reporting the highest median of DDDs (106 709 DDDs), highest median of AUD (60 DDDs per 100 inpatients per day), and bigger median of drug variety (71 types of drug) (Table 1)

Summary

Introduction

With dwindling numbers of new antibiotics being developed and widespread inappropriate use of current antibiotics, antibiotic resistance has emerged as a common and growing issue in healthcare institutions worldwide [1]. Excessive use and misuse of antibiotics results in drug resistance and the emergence of “superbugs” [2], increasing the risk of adverse drug reactions [3], potential infections, and even death [4]. Due to challenges in their management and treatment, antibiotic-resistant infections place a heavy burden on the healthcare systems of developing countries [1, 5]. Appropriate antibiotic use and effective stewardship are crucial for global countries in fighting increasing antimicrobial resistance and preventing the worst-case scenario of having “no antibiotic to use” [6,7,8,9].

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