Abstract：
Over the past 20 years, excessive antibiotic use has led to serious antimicrobial resistance (AMR) worldwide, and the phenomenon is particularly serious in China. To this end, the Chinese health sector took a series of measures to promote rational antibiotic use. In this study, to reveal the impact of policies on antibiotic use, we explored the long-term trend and patterns of antibiotic use at public health care institutions from 2012 to 2020 in northwest China, taking Gansu Province as an example.
Antibiotic procurement data were obtained from the provincial centralized bidding procurement (CBP) platform between 2012 and 2020. Antibiotic use was quantified using the Anatomical Therapeutic Chemical (ATC)/defined daily doses (DDD) methodology and standardized using the DDD per 1000 inhabitants per day (DID). Twelve relevant quality indicators were calculated for comparison with the European Surveillance of Antimicrobial Consumption (ESAC) project monitoring results.
Total antibiotic use increased from 18.75 DID to 57.07 DID and then decreased to 19.11 DID, a turning point in 2014. The top three antibiotics used were J01C (beta-lactam antibacterials, penicillins), J01F (macrolides, lincosamides and streptogramins), and J01D (other beta-lactam antibacterials, cephalosporins), accounting for 45.15%, 31.40%, and 11.99% respectively. The oral antibiotics used were approximately 2.5 times the parenteral antibiotics, accounting for 71.81% and 28.19%, respectively. Different use preferences were shown in public hospitals and primary health care centres (PHCs), and the latter accounted for more than half of total use. The absolute use of all classes of antibiotics in Gansu is almost higher than any of the 31 European countries included in the ESAC, but the relative use of some focused antibiotics is lower than theirs.
The intervention policies of the health department reduced antibiotic use in Gansu Province, but the proportion of broad-spectrum and parenteral antibiotics was still high. It is necessary to further improve the quality of antibiotic prescriptions and pay more attention to the rationality of antibiotic use in PHCs.
Antibiotic procurement data were obtained from the provincial centralized bidding procurement (CBP) platform between 2012 and 2020. Antibiotic use was quantified using the Anatomical Therapeutic Chemical (ATC)/defined daily doses (DDD) methodology and standardized using the DDD per 1000 inhabitants per day (DID). Twelve relevant quality indicators were calculated for comparison with the European Surveillance of Antimicrobial Consumption (ESAC) project monitoring results.
Total antibiotic use increased from 18.75 DID to 57.07 DID and then decreased to 19.11 DID, a turning point in 2014. The top three antibiotics used were J01C (beta-lactam antibacterials, penicillins), J01F (macrolides, lincosamides and streptogramins), and J01D (other beta-lactam antibacterials, cephalosporins), accounting for 45.15%, 31.40%, and 11.99% respectively. The oral antibiotics used were approximately 2.5 times the parenteral antibiotics, accounting for 71.81% and 28.19%, respectively. Different use preferences were shown in public hospitals and primary health care centres (PHCs), and the latter accounted for more than half of total use. The absolute use of all classes of antibiotics in Gansu is almost higher than any of the 31 European countries included in the ESAC, but the relative use of some focused antibiotics is lower than theirs.
The intervention policies of the health department reduced antibiotic use in Gansu Province, but the proportion of broad-spectrum and parenteral antibiotics was still high. It is necessary to further improve the quality of antibiotic prescriptions and pay more attention to the rationality of antibiotic use in PHCs.
摘要：
背景：在过去的20年里，过度使用抗生素导致全球严重的抗菌素耐药性(AMR)，这种现象在中国尤为严重。为此,中国卫生部门采取了一系列措施促进抗生素的合理使用。在这项研究中,为了揭示政策对抗生素使用的影响，我们探索了2012年至2020年西北地区公共医疗机构抗生素使用的长期趋势和模式，以甘肃省为例。
方法：从省级集中招标采购（CBP）平台获取2012年至2020年的抗生素采购数据。抗生素使用使用使用解剖治疗化学品(ATC)/确定的日剂量(DDD)方法进行定量,并使用每天每1000名居民的DDD(DID)进行标准化。计算了12项相关质量指标，以与欧洲抗菌素消费监测（ESAC）项目监测结果进行比较。
结果：抗生素使用总量从18.75DID增加到57.07DID，然后减少到19.11DID，2014年的转折点使用的前三种抗生素是J01C(β-内酰胺抗菌药物，青霉素)，J01F(大环内酯类，lincosamidesandstreptogramins),和J01D（其他β-内酰胺抗菌药物，头孢菌素），占45.15%，31.40%，和11.99%。使用的口服抗生素大约是肠胃外抗生素的2.5倍，占71.81%和28.19%，分别。公立医院和初级卫生保健中心(PHCs)显示了不同的使用偏好，后者占总使用量的一半以上。甘肃各类抗生素的绝对使用量几乎高于ESAC所包括的31个欧洲国家中的任何一个，但是一些重点抗生素的相对使用量低于他们的。
结论：甘肃省卫生部门的干预政策减少了抗生素的使用。但是广谱和肠胃外抗生素的比例仍然很高。有必要进一步提高抗生素处方质量，并更加关注PHCs中抗生素使用的合理性。
方法：从省级集中招标采购（CBP）平台获取2012年至2020年的抗生素采购数据。抗生素使用使用使用解剖治疗化学品(ATC)/确定的日剂量(DDD)方法进行定量,并使用每天每1000名居民的DDD(DID)进行标准化。计算了12项相关质量指标，以与欧洲抗菌素消费监测（ESAC）项目监测结果进行比较。
结果：抗生素使用总量从18.75DID增加到57.07DID，然后减少到19.11DID，2014年的转折点使用的前三种抗生素是J01C(β-内酰胺抗菌药物，青霉素)，J01F(大环内酯类，lincosamidesandstreptogramins),和J01D（其他β-内酰胺抗菌药物，头孢菌素），占45.15%，31.40%，和11.99%。使用的口服抗生素大约是肠胃外抗生素的2.5倍，占71.81%和28.19%，分别。公立医院和初级卫生保健中心(PHCs)显示了不同的使用偏好，后者占总使用量的一半以上。甘肃各类抗生素的绝对使用量几乎高于ESAC所包括的31个欧洲国家中的任何一个，但是一些重点抗生素的相对使用量低于他们的。
结论：甘肃省卫生部门的干预政策减少了抗生素的使用。但是广谱和肠胃外抗生素的比例仍然很高。有必要进一步提高抗生素处方质量，并更加关注PHCs中抗生素使用的合理性。
