Antibiotic use in pulmonology wards of Chinese children’s hospitals: 2002-2006

Zhang, W; Liu, X; Wang, Y; Chen, Y; Huang, Min; Fan, Moli; Lü, Min; Huang, Ying; Wang, L; Yao, Kaihu; Yu, Sangjie; Shen, Xuzhuang; Yang, Yonghong

doi:10.1111/j.1365-2710.2008.01001.x

Cited by 12 publications

(7 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To curb the inflated prices and the overuse of medicines, the Chinese government instituted several policy interventions, including enforcing a price ceiling on some targeted products such as antibiotics [ 21 , 22 ], issuing antibiotic guidelines, and imposing a target on the sale of medicines as a percentage of the total revenue of hospitals [ 2 , 23 , 24 ]. Unfortunately, the outcome was unexpected.…”

Section: Introductionmentioning

confidence: 99%

Effects of County Public Hospital Reform on Procurement Costs and Volume of Antibiotics: A Quasi-Natural Experiment in Hubei Province, China

Tang

Liu

et al. 2018

PharmacoEconomics

View full text Add to dashboard Cite

BackgroundThe overuse of antibiotics has become a major public health challenge worldwide, especially in low- and middle-income countries, including China. In 2009, the Chinese government launched a series of measures to de-incentivise over-prescription in public health facilities, including decoupling the link between facility income and the sale of medicines.ObjectivesWe evaluated the effects of these measures on procurement costs and the volume of antibiotics in county public hospitals.MethodsThe study was undertaken in the Hubei province of China, where 64 county public hospitals implemented the reform in sequence at three different stages. A quasi-natural experiment design was employed. We performed generalised linear regressions with a difference-in-differences approach using 22,713 procurement records of antibiotics from November 2014 to December 2016.ResultsThe regression results showed that the reform contributed to a 14.79% increase in total costs for antibiotics (p = 0.013), particularly costs for injectable antibiotics (p = 0.022) and first-line antibiotics (p = 0.030). The procurement prices for antibiotics remained largely comparable to those in the control group, but the reform led to a 17.30% increase in the procurement volume (expressed as defined daily doses) of second-line antibiotics (p = 0.032).ConclusionsCounty public hospitals procured more antibiotics and greater numbers of expensive antibiotics, such as those administered via injection, to compensate for the loss of income from the sale of medicines, leading to an increased total cost of antibiotics.Electronic supplementary materialThe online version of this article (10.1007/s40273-018-0654-1) contains supplementary material, which is available to authorized users.

show abstract

Section: Introductionmentioning

confidence: 99%

Effects of County Public Hospital Reform on Procurement Costs and Volume of Antibiotics: A Quasi-Natural Experiment in Hubei Province, China

Tang

Liu

et al. 2018

PharmacoEconomics

View full text Add to dashboard Cite

show abstract

“…On average, each Chinese resident takes 138 g of antibiotics per year, tenfold greater than the average in the U.S.A. [2]. Existing studies on antibiotics in China have focused on unnecessary prescribing of antibiotics in urban areas or eastern provinces [3,4] or antibiotic resistance in eastern provinces [5–7]. Up to now, there have been very few studies conducted in western rural provinces of China where the inappropriate use of antibiotics may be at a greater level due to the relatively weak health system [8].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic prescribing for upper respiratory infections among children in rural China: a cross-sectional study of outpatient prescriptions

Zhang¹,

Zou

et al. 2017

Global Health Action

View full text Add to dashboard Cite

Background: Overuse of antibiotics contributes to the development of antimicrobial resistance.Objective: This study aims to assess the condition of antibiotic use at health facilities at county, township and village levels in rural Guangxi, China.Methods: We conducted a cross-sectional study of outpatient antibiotic prescriptions in 2014 for children aged 2–14 years with upper respiratory infections (URI). Twenty health facilities were randomly selected, including four county hospitals, eight township hospitals and eight village clinics. Prescriptions were extracted from the electronic records in the county hospitals and paper copies in the township hospitals and village clinics.Results: The antibiotic prescription rate was higher in township hospitals (593/877, 68%) compared to county hospitals (2736/8166, 34%) and village clinics (96/297, 32%) (p < 0.001). Among prescriptions containing antibiotics, county hospitals were found to have the highest use rate of broad-spectrum antibiotics (82 vs 57% [township], vs 54% [village], p < 0.001), injectable antibiotics (65 vs 43% [township], vs 33% [village], p < 0.001) and multiple antibiotics (47 vs 15% [township], vs 0% [village], p < 0.001). Logistic regression showed that the likelihood of prescribing an antibiotic was significantly associated with patients being 6–14 years old compared with being 2–5 years old (adjusted odds ratio [aOR] = 1.3, 95% CI 1.2–1.5), and receiving care at township hospitals compared with county hospitals (aOR = 5.0, 95% CI 4.1–6.0). Prescriptions with insurance copayment appeared to lower the risk of prescribing antibiotics compared with those without (aOR = 0.8, 95% CI 0.7–0.9).Conclusions: Inappropriate use of antibiotics was high for outpatient childhood URI in the four counties of Guangxi, China, with the highest rate found in township hospitals. A significant high proportion of prescriptions containing antibiotics were broad-spectrum, by intravenous infusion or with multiple antibiotics, especially at county hospitals. Urgent attention is needed to address this challenge.

show abstract

“…Seven of these applied the ATC/DDD methodology. Four studies described antibiotic prescribing in hospitalised children in China, reporting the same data taken from pharmacy records over a 5‐year period 27,28,30,31 . A further two studies from Iran, and one from Indonesia applied this recognised methodology, although the paediatric data available were limited 32–34 .…”

Section: Resultsmentioning

confidence: 99%

Measuring antibiotic prescribing in hospitalised children in resource‐poor countries: A systematic review

Irwin

2011

J Paediatrics Child Health

View full text Add to dashboard Cite

Antibiotic resistance represents a significant threat to global health. Widespread exposure to antibiotics drives the development of antibiotic resistance. Little is known about the exposure to antibiotics of hospitalised children, particularly in resource-poor countries where the burden of infectious disease is highest. The review sought to identify original research quantifying antibiotic use in hospitalised children in resource countries. The methods used were: A systematic search of the MEDLINE, CINAHL, EMBASE, LILACS and African Index Medicus databases. Eighteen papers were identified and the methodology varied considerably. Only seven used a recognised defined daily dose (DDD) methodology. The studies reveal a high exposure of hospitalised children to antibiotics. With the exception of data from China, the studies were limited by their design. Limited evidence of the variation in drug, dose and total exposure to antibiotic use in hospitalised children in resource-poor countries exists. An international network of surveillance of both antimicrobial prescribing and resistance using a simple standardised methodology in this context remains an important goal. A simplified paediatric version of the adult DDD methodology is required to allow international comparison between populations.

show abstract

Antibiotic use in pulmonology wards of Chinese children’s hospitals: 2002-2006

Cited by 12 publications

References 19 publications

Effects of County Public Hospital Reform on Procurement Costs and Volume of Antibiotics: A Quasi-Natural Experiment in Hubei Province, China

Effects of County Public Hospital Reform on Procurement Costs and Volume of Antibiotics: A Quasi-Natural Experiment in Hubei Province, China

Antibiotic prescribing for upper respiratory infections among children in rural China: a cross-sectional study of outpatient prescriptions

Measuring antibiotic prescribing in hospitalised children in resource‐poor countries: A systematic review

Contact Info

Product

Resources

About