Pathways to optimising antibiotic use in Anhui: Identifying key determinants in community and clinical settings

点击翻译按钮获取中文摘要

Widespread antibiotic use is considered to be a major contributor to the growing problem of antimicrobial resistance in many countries, but there is a lack of evidence regarding its key drivers in China, particularly in rural settings and outside hospitals, and whether these differ from those found elsewhere. This evidence is essential for identifying the health system, behavioural and policy interventions that have most potential for limiting the spread of antibiotic resistance in China, while ensuring equitable access to antibiotics for essential treatment of bacterial infections. This innovative interdisciplinary project aims to acquire greater understanding of key social, economic, cultural, systemic and other influences on antibiotic use by investigating and quantifying current use of both prescribed and non-prescribed antibiotics and other forms of care to treat common infections in rural parts of Anhui Province. Our study will document treatment-seeking practices for selected common infections from all sources (including informal, Traditional Chinese Medicine (TCM), folk, home-based, private and government medical care) among patients at local health facilities and in the general population. We will gather information on testing, clinical diagnosis and antibiotic treatment procedures at lower levels of the health system and on over-the-counter purchasing of antibiotics from pharmacies and medicine shops. We will ascertain the annual incidence of common respiratory tract infections in the population of Anhui Province and assess the effects of the different forms of treatment they use, including antibiotics, on reported severity and duration of illness. We will also ascertain the feasibility of assessing clinical diagnostic accuracy, relationship between patient-reported symptoms and clinical diagnosis, and burden of antibiotic resistance in non-hospitalised patients, and investigate possible population biases in existing laboratory data through microbiological sampling. This range of evidence will enable us to formulate recommendations for appropriate interventions to optimise the use of antibiotics in Anhui Province and other regions of China.