Lancet sub-issue: Shock! 170 million consultation data reveal the unreasonable status quo of antibiotic use in China!

Increased resistance to bacterial antibiotics and a lack of new antibiotics are major bacterial infection-related health problems worldwide.
use of antibiotics and targeted dosing seem to be one of the few ways to maintain their effectiveness and limit the emergence of drug resistance.
current human antibiotic abuse has made infections, including neo-coronary pneumonia, more difficult to treat.
figures show that thousands of people die each year in the UK each year from drug-resistant superbugs.
, at the 2019 World Economic Forum in Davos, Switzerland, British health officials pointed out that drug-resistant superbugs, like climate change, are an important threat to humanity today.
Previously, a study of more than 500 patients by researchers from the University of Geneva, the University of Lausanne and the University Hospital of Vadoy, Switzerland, found that adjusting antibiotic treatment options based on each patient's individual characteristics and disease patterns is expected to reduce drug doses and avoid bacterial resistance without losing treatment.
is the world's largest antibiotic production, consumption accounted for half of the world's countries.
, compared with Europe and the United States and other countries, China's antibiotic abuse problem has been more serious.
, according to the latest research data from the Chinese Academy of Sciences, the daily use of antibiotics per 1,000 people in China is 5.7 times that of the United Kingdom and 5.5 times that of the United States.
is it reasonable to use so many antibiotics? No one has answered this question so far.
this end, the team from Peking University School of Public Health and the Seventh Medical Center of PLA General Hospital conducted a comprehensive assessment of the rationality of outpatient antibiotic prescriptions in Chinese second- and third-level hospitals.
results were published in the latest Lancet Infectious Disease journal.
researchers used data from the Beijing Center for Rational Drug Use, a national database designed to monitor the rationality of drug use.
included diagnostic and prescription information Chinese mainland 139 hospitals from 28 provincial districts in the united States.
, according to the current general classification scheme, outpatient prescriptions are classified as reasonable, possibly reasonable, unreasonable or unrelated to any diagnosis of antibiotic use.
the researchers then assessed the rate of antibiotic prescriptions for different diagnostic categories and the proportion of inappropriate antibiotic prescriptions for different subcategories.
the proportion of antibiotic prescription patterns and individual antibiotic prescriptions for different diagnostic categories was analyzed and reported.
results show that between 1 October 2014 and 30 April 2018, more than 170 million outpatient data were included in the final analysis.
, nearly 19 million (10.9 per cent) of these clinics were prescribed antibiotics.
of all antibiotic use, 51.4% (9689937) were unreasonable, 28.4% (5354224) were reasonable, 15.3% (2893102) were reasonable, and 4.8% (911601) had nothing to do with any diagnosis.
further analysis showed that in the study, medical staff prescribed more than 2,300 doses of individual antibiotics and more than 18 million doses of broad-spectrum antibiotics (80.0%).
, the top four antibiotics prescribed were third-generation cephalosporins (more than 5 million).
7 per cent), second-generation cephalosporins (more than 3.8 million (16.4 per cent), large cycloesters (nearly 3.6 million (15.3 per cent),) and fluoroquinolone (nearly 3.3 million (14.1 per cent).
article, the team notes that unreasonable antibiotic prescriptions are common in China, and that more than half of antibiotic prescriptions in secondary and third-tier hospitals are unreasonable.
shows the urgent need for outpatient antibiotic management and optimized antibiotic prescriptions to meet the targets set in China's 2016 national action plan to curb antibiotic resistance.
, improper use of antibiotics can greatly accelerate antibiotic resistance.
the abuse of antibiotics in China is very serious.
, it is urgent for relevant departments to issue standardized management policies to better guide drug use.
: Zhao H, et al. Appropriateness of antibiotic prescriptions in ambulatory care in China: a nationwide descriptive database study. Lancet Infect Dis. 2021 Jan 27:S1473-3099 (20) 30596-X. doi: 10.1016/S1473-3099 (20)30596-X.MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Originals" are owned by Mets Medicine and are not reproduced by any media, website or individual without authorization, and are authorized to be reproduced with the words "Source: Mets Medicine".
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