Nan Ren1, Pengcheng Zhou1, Ximao Wen1, Chunhui Li1, Xun Huang1, Yanhong Guo2, Li Meng2, Ruie Gong1, Li Feng1, Chenchao Fu1, Anhua Wu3. 1. Infection Control Center, Xiangya Hospital, Central South University, Changsha, Hunan, China. 2. Medical Administration Bureau, National Health and Family Planning Commission of the People's Republic of China, Beijing, China. 3. Infection Control Center, Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: xywuanhua@csu.edu.cn.
Abstract
BACKGROUND: In China, several measures have been adopted to decrease unnecessary antimicrobial overuse since 2010. This study aimed to identify characteristics of antimicrobial use in Chinese hospitals after implementing these measures and to explore additional targets for future antimicrobial stewardship. METHODS: In 2012, point prevalence surveys conducted in Chinese hospitals included inpatients who were admitted for at least 24 hours. Details regarding infection, antimicrobial use, and bacterial cultures were recorded. RESULTS: A survey of 786,028 inpatients in 1,313 hospitals included prevalence of health care-associated (3.22%) and community-acquired infections (22.52%); antimicrobial use prevalence (AUP, 38.39%); bacterial culture rate (BCR, 40.16%); and proportions of administration of a single antimicrobial (75.33%), therapeutic (23.16%), prophylactic (11.99%), and therapeutic plus prophylactic (3.24%) AUP rates. Prophylactic AUP rates of hospitals with <300, 300-599, 600-899, and ≥900 beds were 14.23%, 12.45%, 11.45%, and 11.34%, respectively. However, BCRs increased with increasing hospital bed numbers. AUP rates for surgical patients with classes I, II, and III wounds were 45.19%, 68.18%, and 68.47%, respectively. Prophylactic AUP rates for surgical patients decreased with increasing hospital bed numbers. These indices varied among different hospital departments. CONCLUSION: More efforts are needed toward small hospitals, prophylactic antimicrobial use for surgical patients, and departments with low BCRs to optimize the clinical antimicrobial use.
BACKGROUND: In China, several measures have been adopted to decrease unnecessary antimicrobial overuse since 2010. This study aimed to identify characteristics of antimicrobial use in Chinese hospitals after implementing these measures and to explore additional targets for future antimicrobial stewardship. METHODS: In 2012, point prevalence surveys conducted in Chinese hospitals included inpatients who were admitted for at least 24 hours. Details regarding infection, antimicrobial use, and bacterial cultures were recorded. RESULTS: A survey of 786,028 inpatients in 1,313 hospitals included prevalence of health care-associated (3.22%) and community-acquired infections (22.52%); antimicrobial use prevalence (AUP, 38.39%); bacterial culture rate (BCR, 40.16%); and proportions of administration of a single antimicrobial (75.33%), therapeutic (23.16%), prophylactic (11.99%), and therapeutic plus prophylactic (3.24%) AUP rates. Prophylactic AUP rates of hospitals with <300, 300-599, 600-899, and ≥900 beds were 14.23%, 12.45%, 11.45%, and 11.34%, respectively. However, BCRs increased with increasing hospital bed numbers. AUP rates for surgical patients with classes I, II, and III wounds were 45.19%, 68.18%, and 68.47%, respectively. Prophylactic AUP rates for surgical patients decreased with increasing hospital bed numbers. These indices varied among different hospital departments. CONCLUSION: More efforts are needed toward small hospitals, prophylactic antimicrobial use for surgical patients, and departments with low BCRs to optimize the clinical antimicrobial use.
Authors: Charlotte Jackson; Yingfen Hsia; Julia A Bielicki; Sally Ellis; Peter Stephens; Ian C K Wong; Mike Sharland Journal: BMJ Glob Health Date: 2019-02-27
Authors: Abdul Haseeb; Hani Saleh Faidah; Manal Algethamy; Saleh Alghamdi; Ghaidaa Ali Alhazmi; Afnan Owedah Alshomrani; Bashair Rjyan Alqethami; Hind Saeed Alotibi; Maali Zayed Almutiri; Khawlah Saad Almuqati; Amjad Abdullah Albishi; Mahmoud Essam Elrggal; Ahmad Jamal Mahrous; Asim Abdulaziz Khogeer; Zikria Saleem; Muhammad Shahid Iqbal; Aziz Sheikh Journal: Int J Environ Res Public Health Date: 2021-12-27 Impact factor: 3.390