Jiao-Sheng Zhang1, Gang Liu2, Wen-Shuang Zhang3, Hai-Yan Shi4, Gen Lu5, Chang-An Zhao6, Chang-Chong Li7, Yan-Qi Li8, Ya-Nan Shao9, Dai-Yin Tian10, Ming-Jie Ding11, Chun-Yan Li12, Li-Juan Luo13, Xiao-Yan Dong14, Ping Jin15, Ping Wang16, Chun-Mei Zhu17, Chuan-Qing Wang18, Yue-Jie Zheng19, Ji-Kui Deng1, Mike Sharland20, Ying-Fen Hsia20, Kun-Ling Shen21, Yong-Hong Yang22. 1. Department of Infectious diseases, Shenzhen Children's Hospital, Shenzhen, China. 2. Department of Infectious diseases, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, China. 3. Department of Respiratory Medicine, Tianjin Children's Hospital, Tianjin, China. 4. Department of Pharmacology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China. 5. Department of Respiratory Medicine, Guangzhou Women and Children's Medical Center, Guangzhou, China. 6. Emergency Department, Guangdong Maternal and Child Health Care Hospital, Guangzhou, China. 7. Department of Pediatric Respiratory Medicine, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China. 8. Department of Respiratory Medicine, Xi'an Children's Hospital, Xi'an, China. 9. Department of Respiratory Medicine, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. 10. Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China. 11. Department of Respiratory Medicine, Jinan Children's Hospital, Jinan, China. 12. Department of Respiratory Medicine, The First Hospital of Jilin University, Changchun, China. 13. Department of Infectious diseases, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. 14. Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai, China. 15. Pediatric Intensive Care Unit, Bao'an Maternity and Child Health Hospital, Shenzhen, China. 16. Neonatal Department, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China. 17. Department of Respiratory Medicine, Children's Hospital Attached to The Capital Institute of Pediatrics, Beijing, China. 18. Infection-control Department, Fudan University Pediatric Hospital, Shanghai, China. 19. Department of Respiratory Medicine, Shenzhen Children's Hospital, Shenzhen, China. 20. Pediatric Infectious Diseases Research Group, St George's, University of London, London, UK. 21. Department of Respiratory Medicine, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, China. 22. Beijing Pediatric Research Institute, Beijing Children's Hospital Affiliated to Capital Medical University, 56 Nanlishi Road, Beijing, China. yyh628628@sina.com.
Abstract
BACKGROUND: Children as a population have high antimicrobial prescribing rates which may lead to high resistance of bacteria according to data from some single-center surveys of antibiotic prescribing rates in China. The acquirement of baseline data of antibiotic prescribing is the basis of developing intervention strategies on inappropriate antimicrobial prescriptions. Few studies show clearly the pattern and detailed information on classes of antibiotics and distribution of indications of antibiotic prescriptions in children in China. This study aims to assess the antibiotic prescribing patterns among children and neonates hospitalized in 18 hospitals in China. METHODS: A 24-hour point prevalence survey on antimicrobial prescribing was conducted in hospitalized neonates and children in China from December 1st, 2016 to February 28th, 2017. Information on the antibiotic use of patients under 18 years of age who were administered one or more on-going antibiotics in the selected wards over a 24-hour period was collected. These data were submitted to the GARPEC (Global Antimicrobial Resistance, Prescribing and Efficacy in Children and Neonates) web-based application ( https://pidrg-database.sgul.ac.uk/redcap/ ). For statistical analysis, Microsoft Excel 2007 and SPSS 22.0 were used. RESULTS: The antibiotic data were collected in 35 wards in 18 hospitals from 9 provinces. In total, 67.76% (975/1439) of the patients (n = 1439) were given at least one antibiotic, including 58.1% (173/298) of neonates (n = 298) and 70.3% (802/1141) of children (n = 1141). In neonates, the three most frequently prescribed antibiotics were third-generation cephalosporins (41.7%), penicillins plus enzyme inhibitor (23.8%), and carbapenems (11.2%). In children, the three most frequently prescribed antibiotics were third-generation cephalosporins (35.5%), macrolides (23.2%), and penicillins plus enzyme inhibitors (15.9%). The most common indication for antibiotics was proven or probable bacterial lower respiratory tract infection (30.9% in neonates and 66.6% in children). CONCLUSIONS: Antibiotics are commonly prescribed in the Chinese children population. It is likely that the third-generation cephalosporins and macrolides are currently overused in Chinese children. Efforts must be made to ensure safe and appropriate antibiotic prescribing to reduce and prevent the future development of antibiotic resistance.
BACKGROUND:Children as a population have high antimicrobial prescribing rates which may lead to high resistance of bacteria according to data from some single-center surveys of antibiotic prescribing rates in China. The acquirement of baseline data of antibiotic prescribing is the basis of developing intervention strategies on inappropriate antimicrobial prescriptions. Few studies show clearly the pattern and detailed information on classes of antibiotics and distribution of indications of antibiotic prescriptions in children in China. This study aims to assess the antibiotic prescribing patterns among children and neonates hospitalized in 18 hospitals in China. METHODS: A 24-hour point prevalence survey on antimicrobial prescribing was conducted in hospitalized neonates and children in China from December 1st, 2016 to February 28th, 2017. Information on the antibiotic use of patients under 18 years of age who were administered one or more on-going antibiotics in the selected wards over a 24-hour period was collected. These data were submitted to the GARPEC (Global Antimicrobial Resistance, Prescribing and Efficacy in Children and Neonates) web-based application ( https://pidrg-database.sgul.ac.uk/redcap/ ). For statistical analysis, Microsoft Excel 2007 and SPSS 22.0 were used. RESULTS: The antibiotic data were collected in 35 wards in 18 hospitals from 9 provinces. In total, 67.76% (975/1439) of the patients (n = 1439) were given at least one antibiotic, including 58.1% (173/298) of neonates (n = 298) and 70.3% (802/1141) of children (n = 1141). In neonates, the three most frequently prescribed antibiotics were third-generation cephalosporins (41.7%), penicillins plus enzyme inhibitor (23.8%), and carbapenems (11.2%). In children, the three most frequently prescribed antibiotics were third-generation cephalosporins (35.5%), macrolides (23.2%), and penicillins plus enzyme inhibitors (15.9%). The most common indication for antibiotics was proven or probable bacterial lower respiratory tract infection (30.9% in neonates and 66.6% in children). CONCLUSIONS: Antibiotics are commonly prescribed in the Chinese children population. It is likely that the third-generation cephalosporins and macrolides are currently overused in Chinese children. Efforts must be made to ensure safe and appropriate antibiotic prescribing to reduce and prevent the future development of antibiotic resistance.
Authors: Ekaterina Blinova; Elaine Lau; Ari Bitnun; Peter Cox; Steven Schwartz; Eshetu Atenafu; Yvonne Yau; Laurie Streitenberger; Christopher S Parshuram; John Marshall; Winnie Seto Journal: Pediatr Crit Care Med Date: 2013-07 Impact factor: 3.624
Authors: Ann Versporten; Julia Bielicki; Nico Drapier; Mike Sharland; Herman Goossens Journal: J Antimicrob Chemother Date: 2016-01-08 Impact factor: 5.790
Authors: Maia De Luca; Daniele Donà; Carlotta Montagnani; Andrea Lo Vecchio; Marta Romanengo; Claudia Tagliabue; Chiara Centenari; Patrizia D'Argenio; Rebecca Lundin; Carlo Giaquinto; Luisa Galli; Alfredo Guarino; Susanna Esposito; Mike Sharland; Ann Versporten; Herman Goossens; Giangiacomo Nicolini Journal: PLoS One Date: 2016-05-16 Impact factor: 3.240