Inpatient antibacterial use trends and patterns, China, 2013–2021

作者：Haishaerjiang Wushouer, Yue Zhou, Wanmeng Zhang, Lin Hu, Kexin Du, Yaoyao Yang, Guiqing Yao, Paul Little, Bo Zheng, Xiaodong Guan, Luwen Shi · 发表于：Bulletin of the World Health Organization · 年份：2023 · DOI：10.2471/blt.22.288862 · 被引用次数：17 · 研究领域：Antibiotic Use and Resistance、Antibiotic Resistance in Bacteria、Antibiotics Pharmacokinetics and Efficacy

Objective To analyse trends and patterns in inpatient antibacterial use in China's tertiary and secondary hospitals between 2013 and 2021. Methods The analysis involved quarterly data from hospitals covered by China's Center for Antibacterial Surveillance. We obtained information on hospital characteristics (e.g. province, a de-identified hospital code, hospital level and inpatient days) and antibacterial characteristics (e.g. generic name, drug classification, dosage, administration route and usage volume). We quantified antibacterial use as the number of daily defined doses per 100 patient-days. The analysis took into account the World Health Organization's (WHO's) Access, Watch, Reserve classification of antibiotics. Findings Between 2013 and 2021, overall antibacterial use in inpatients decreased significantly from 48.8 to 38.0 daily defined doses per 100 patient-days (P < 0.001). In 2021, the variation between provinces was almost twofold: 29.1 daily defined doses per 100 patient-days in Qinghai versus 55.3 in Tibet. The most-used antibacterials in both tertiary and secondary hospitals throughout the study period were third-generation cephalosporins, which comprised around one third of total antibacterial use. Carbapenems entered the list of most-used antibacterial classifications in 2015. The most frequently used antibacterials in WHO's classification belonged to the Watch group: usage increased significantly from 61.3% (29.9/48.8) in 2013 to 64.1% (24.4/38.0) in 2021 (...