Change in Antibiotic Use in Secondary and Tertiary Hospitals Nationwide After a National Antimicrobial Stewardship Campaign Was Launched in China, 2011-2016: An Observational Study.
BACKGROUND
An antimicrobial stewardship campaign was launched in 2011 by the Ministry of Health. This study aimed to assess the achievements and trends in the clinical use of antibiotics in secondary and tertiary hospitals following this campaign in China.


METHODS
This observational study analyzed nationwide hospital antibiotic procurement and consumption data and antibiotic-resistance surveillance data based on claims filed in 2010-2016.


RESULTS
After a 6-year national campaign, the proportion of outpatients and surgical patients who received antibiotic treatment decreased from 19.5% to 8.5% and from 97.9% to 38.3%, respectively. The intensity of antibiotic use among inpatients decreased from 85.3±29.8 defined daily dosage (DDD) per 100 patient days to 48.5±8.0 DDD per 100 patient days. Moreover, the antibiotic procurement expenditure among hospitals declined from 22.3% of total drug procurement costs in 2010 to 12.1% in 2016, although total drug procurement costs doubled during that time. The incidence of methicillin-resistant Staphylococcus aureus isolates also dropped (from 54.4% in 2010 to 34.4% in 2016), as did the proportion of carbapenem-resistant Pseudomonas aeruginosa isolates (from 30.8% to 22.3%).


CONCLUSIONS
The 6-year campaign successfully reduced antibiotic consumption and irrational drug use in Chinese hospitals which was associated with declines in the prevalence of common antibiotic-resistant bacteria.
['Xiao|Yonghong|Y|', 'Shen|Ping|P|', 'Zheng|Beiwen|B|', 'Zhou|Kai|K|', 'Luo|Qixia|Q|', 'Li|Lanjuan|L|']
D000900:Anti-Bacterial Agents D000073602:Antimicrobial Stewardship D001424:Bacterial Infections D002681:China D024881:Drug Resistance, Bacterial D005102:Health Expenditures D006801:Humans D055624:Methicillin-Resistant Staphylococcus aureus D011552:Pseudomonas Infections D011550:Pseudomonas aeruginosa D013203:Staphylococcal Infections D062606:Tertiary Care Centers
stewardship China antimicrobial resistance