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Abstract：
BACKGROUND: Problems of irrational antibiotic use by prescribers are ongoing and have escalated following reductions in the cost of essential drugs policy. In an attempt to improve prescribing practices for village doctors and rational use of essential drugs, a program designed to audit and monitor drug use was established. However, the effects of the program to control antibiotic resistance and changing the village doctors\' prescribing behaviors remain largely unknown. This study measured the effect of the program on levels of antibiotic use.
METHODS: Data was collected covering a 22-month period, before, during and after the program was implemented in rural clinics. Segmented regression analysis with interrupted time series (ITS) data was used to examine whether there had been a significant interaction with the onset of the program in September 2011 and levels of antibiotic use from November 2010 to August 2012. Both serial and 12-month lag autocorrelations were controlled for.
RESULTS: A noticeable drop about 6.15% per month (95% CI: -13.36%; 1.06%, P = 0.089) for the antibiotic use in outpatients, which is lower of effect size assuming that the program has the immediate impact of the program were captured for the immediate effect of the program. Meanwhile, levels of antibiotic use would have continued to decrease by 1.12% per month (P = 0.034) as they did in the absence of the program.
CONCLUSIONS: The central finding was that the prescription audit and feedback program was associated with significant decreases (P = 0.034) in antibiotic use after its implementation.
METHODS: Data was collected covering a 22-month period, before, during and after the program was implemented in rural clinics. Segmented regression analysis with interrupted time series (ITS) data was used to examine whether there had been a significant interaction with the onset of the program in September 2011 and levels of antibiotic use from November 2010 to August 2012. Both serial and 12-month lag autocorrelations were controlled for.
RESULTS: A noticeable drop about 6.15% per month (95% CI: -13.36%; 1.06%, P = 0.089) for the antibiotic use in outpatients, which is lower of effect size assuming that the program has the immediate impact of the program were captured for the immediate effect of the program. Meanwhile, levels of antibiotic use would have continued to decrease by 1.12% per month (P = 0.034) as they did in the absence of the program.
CONCLUSIONS: The central finding was that the prescription audit and feedback program was associated with significant decreases (P = 0.034) in antibiotic use after its implementation.
摘要：
背景：处方者不合理使用抗生素的问题正在持续存在，并且随着基本药物政策成本的降低而升级。试图改善乡村医生的处方做法,合理使用基本药物,建立了一个旨在审计和监测药物使用的程序。然而,控制抗生素耐药性和改变乡村医生处方行为的计划的效果在很大程度上仍然未知。这项研究测量了该计划对抗生素使用水平的影响。
方法：收集了22个月的数据，之前，在农村诊所实施该计划期间和之后。使用中断时间序列（ITS）数据进行分段回归分析，以检查是否与2011年9月的计划开始以及2010年11月至2012年8月的抗生素使用水平存在显着相互作用。控制了连续和12个月滞后的自相关。
结果：每月明显下降约6.15%（95%CI：-13.36%；1.06%，P=0.089）用于门诊患者的抗生素使用，这是效果大小的较低，假设该程序具有该程序的直接影响被捕获为该程序的即时效果。同时,抗生素使用水平将继续每月下降1.12%(P=0.034),与没有该计划的情况一样.
结论：主要发现是处方审核和反馈计划与实施后抗生素使用显着减少有关（P=0.034）。
方法：收集了22个月的数据，之前，在农村诊所实施该计划期间和之后。使用中断时间序列（ITS）数据进行分段回归分析，以检查是否与2011年9月的计划开始以及2010年11月至2012年8月的抗生素使用水平存在显着相互作用。控制了连续和12个月滞后的自相关。
结果：每月明显下降约6.15%（95%CI：-13.36%；1.06%，P=0.089）用于门诊患者的抗生素使用，这是效果大小的较低，假设该程序具有该程序的直接影响被捕获为该程序的即时效果。同时,抗生素使用水平将继续每月下降1.12%(P=0.034),与没有该计划的情况一样.
结论：主要发现是处方审核和反馈计划与实施后抗生素使用显着减少有关（P=0.034）。
