Trends and patterns of antibiotic consumption in Shanghai municipality, China: a 6 year surveillance with sales records, 2009-14
Trends and patterns of antibiotic consumption in Shanghai municipality, China: a 6 year surveillance with sales records, 2009-14
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DOI：
10.1093/jac/dkw013
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发表时间：
2016-06-01
影响因子：
5.2
通讯作者：
Lundborg, Cecilia Stalsby
中科院分区：
文献类型：
--
作者：
Lin, Hai;Dyar, Oliver James;Lundborg, Cecilia Stalsby
目的：目的：分析上海市2009 - 2014年抗菌药物的使用趋势和规律。方法：收集上海市160家医院和241家基层医疗机构的抗菌药物销售记录，作为抗菌药物使用的替代指标。计算了以每1000名居民每天的DDD（DID）表示的抗生素销售额。我们使用欧洲抗菌药物消费监测（ESAC）的指标，将上海市2400万居民的抗生素使用模式与欧洲国家进行了比较。结果：2010年抗生素总使用量最高，为25.9 DID，2012年降至17.8 DID，此后保持稳定。大部分减少发生在2011年的6个月内。2014年，三分之二的抗生素销售给医院（为住院和门诊患者提供服务），三分之一销售给基层医疗机构。头孢菌素类占50.2%，其次为大环内酯类（18.2%）、喹诺酮类（16.0%）和青霉素类（7.3%）。五分之一的所有抗生素都是在parenteral form.Conclusions：我们已经成功地使用汇总的销售数据，以监测抗生素的使用在一个大的城市人口超过6年的时间。整个卫生系统的抗生素使用量迅速、大幅和持续减少。与此同时，卫生部门各级采取了若干干预措施，包括一项全国运动。抗生素的使用模式表明头孢菌素类、大环内酯类、喹诺酮类和胃肠外制剂的持续偏好。需要进一步努力调查和提高抗生素使用的质量。
Objectives: The objective of this study was to identify the trends and patterns of total antibiotic use in Shanghai from 2009 to 2014.Methods: Sales records were collected from a minimum of 160 hospitals and 241 primary healthcare settings and used as a proxy for consumption. Antibiotic sales expressed in DDD per 1000 inhabitants per day (DID) were calculated. We compared patterns of antibiotic use in the Shanghai municipality, populated by 24 million inhabitants, with European countries using indicators from the European Surveillance of Antimicrobial Consumption (ESAC).Results: Total antibiotic use was highest at 25.9 DID in 2010, fell to 17.8 DID in 2012 and remained stable thereafter. The majority of this reduction occurred over 6 months in 2011. In 2014, two-thirds of the antibiotic sales were to hospitals (serving both inpatients and outpatients) and one-third to primary healthcare institutions. Cephalosporins accounted for 50.2% of total DID, followed by macrolides (18.2%), quinolones (16.0%) and penicillins (7.3%). A fifth of all antibiotics were used in pa renteral form.Conclusions: We have successfully used aggregated sales data to monitor antibiotic usage across a Large urban population over a 6 year period. A rapid, substantial and sustained reduction in antibiotic usage across the entire health system occurred. This coincided with several interventions across hierarchies in the health sector, including a national campaign. The patterns of antibiotic use indicate persistent preferences for cephalosporins, macroLides, quinolones and parenteral preparations. Further efforts are needed to investigate and improve the quality of antibiotic use.