Changes in patterns of antibiotic use in Chinese public hospitals (2005-2012) and a benchmark comparison with Sweden in 2012
Changes in patterns of antibiotic use in Chinese public hospitals (2005-2012) and a benchmark comparison with Sweden in 2012
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DOI：
10.1016/j.jgar.2015.03.001
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发表时间：
2015-06-01
影响因子：
4.6
通讯作者：
Dong, Siping
中科院分区：
文献类型：
--
作者：
Sun, Jing;Shen, Xiao;Dong, Siping
报告了全国范围内密集干预前后中国医院抗生素使用模式的变化，并与中国国家目标和瑞典医院抗生素使用情况进行了比较。中国数据按季度和每年从 15 家医院选定的患者处方/医疗记录和药品库存控制系统中收集（2005-2012 年）。瑞典的数据取自 2010 年点患病率调查和七所大学医院 2009-2012 年销售数据。采用分段回归分析的中断时间序列来衡量干预前后中国医院抗生素使用模式的变化。 2011年干预后，中国医院抗生素使用量显着减少：抗生素处方比例下降4.7%（P=0.03），病历中抗生素处方比例下降73%（P=0.04）。 2012年中国医院的抗生素处方和病历比例分别为10%和50%，仍远高于瑞典医院（门诊患者DDD为1.1%，住院患者人数为34%）。中国医院的住院消费从2008年的910DDD/1000住院天大幅下降至2012年的473天（瑞典医院为588天）。中国医院抗生素使用频率较低，仍首选广谱抗生素，整体使用率高于瑞典。干预后观察到住院患者总体抗生素消耗量显着减少。无法确定这些变化是否减少了抗生素的不当使用。需要进一步研究。 (C) 2015 年国际感染和癌症化疗协会。由爱思唯尔有限公司出版。保留所有权利。
Changes in patterns of antibiotic use in Chinese hospitals before and after intensive nationwide interventions are reported and compared with Chinese national targets and antibiotic use in Swedish hospitals. Chinese data were collected quarterly and yearly from selected patient prescriptions/medical records and medicines inventory control systems from 15 hospitals (2005-2012). Swedish data were extracted from a 2010-point prevalence survey and 2009-2012 sales data from seven university hospitals. An interrupted time series with segmented regression analysis was used to measure changes in patterns of antibiotic use in Chinese hospitals before and after the interventions. Following the 2011 interventions, significant reductions in antibiotic use in Chinese hospitals were seen: the proportion of prescriptions with antibiotics decreased 4.7% (P=0.03) and the proportion of medical records with antibiotic prescription decreased 73% (P=0.04). The proportions of prescriptions and medical records with antibiotics in Chinese hospitals in 2012 were 10% and 50%, respectively, and remained much higher than Swedish hospitals (1.1% in DDD for outpatients and 34% in number of patients for inpatients). Inpatient consumption in Chinese hospitals dropped significantly from 910 DDD/1000 inpatient days in 2008 to 473 in 2012 (588 in Swedish hospitals). Antibiotics are being used less frequently in Chinese hospitals, broad-spectrum antibiotics are still preferred, and overall usage is higher than Sweden. A significant reduction in overall inpatient antibiotic consumption was observed after the interventions. It is not possible to identify whether the-changes have resulted in less inappropriate antibiotic use. Further studies are needed. (C) 2015 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.