The national health and Health Commission issued another document, limiting the resistance and never stopping!

Source: Medical Mobile News May 16, 2018 recently, the national health and Health Commission issued a notice to further strengthen the clinical application management of antibacterial drugs We will speed up the construction of a multidisciplinary team for the management and diagnosis and treatment of antimicrobial drugs, and take comprehensive measures to solve the outstanding problems faced by the current use of antimicrobial drugs Strengthen the management of key links in the clinical application of antibacterials and continue to implement the management of special files of antibacterials On the basis of carbapenems, tegacyclin and other special use class antibacterial drugs, it is encouraged to implement the special file management of enzyme inhibitor compound preparation in the tertiary general hospital in the areas where conditions permit We will further implement the requirements for the adjustment of the catalogue of supply of antibacterial drugs and the management of filing We will optimize the structure of product specifications for antimicrobial drugs, timely include the drugs with accurate clinical effect, good economy and low safety risk into the supply catalogue, and gradually eliminate the drugs with poor pharmacokinetic characteristics, many adverse reactions and insufficient evidence-based medicine We should correctly understand the skin (or intradermal) sensitivity test of β - lactam antibiotics, encourage penicillin and other classic antibiotics to be included in the supply catalogue, standardize and use them reasonably, and gradually increase the proportion of their use to reach or close to the international average level Strengthen the standardized use and management of antibacterial drugs Encourage the establishment of the applicable clinical pathway, diagnosis and treatment norms and guidelines for infectious diseases On the basis of paying more attention to the prophylactic drugs in the perioperative period of class I incision, the management of prophylactic antibiotics in the perioperative period of class II incision should be strengthened We should strengthen the training of secondary hospitals and primary medical institutions, improve their technical ability and management level of antimicrobial use, and reduce unreasonable use of prophylactic and intravenous antibiotics To strengthen the management of clinical application of antimicrobial agents in children and strengthen the monitoring and evaluation On the basis of clinical application monitoring network and bacterial resistance monitoring network of antibacterial drugs, the monitoring system for children was established, the number of pediatric ward in children's specialized hospital or general hospital included in the monitoring scope was increased, the index data of clinical application and drug resistance of children's antibacterial drugs were comprehensively mastered, and the evaluation system for children's antibacterial drugs suitable for China's national conditions was established To establish a monitoring system for the use of antibiotics in children's hospital The outpatient and emergency departments should focus on monitoring the use of antibiotics for respiratory and intestinal diseases, and the inpatients should focus on monitoring the use of special use level antibiotics We will focus on strengthening the monitoring of the clinical use of special use level antibacterial drugs, and standardize the granting of prescription authority, case consultation, and submission of microbiological samples Improve the ability and level of diagnosis and treatment of infectious diseases in children According to the characteristics of children's infectious diseases, we should speed up the construction of children's infectious diseases department and the training of infection related medical personnel, strengthen the knowledge training of children's infectious diseases, give full play to the positive role of clinical pharmacists in the rational use of antibiotics, and promote the application of clinical pathway, diagnosis and treatment standards and guidelines for infectious diseases In addition, while strengthening the clinical application management of children's antibacterial drugs, encourage all regions to actively explore and take effective measures to strengthen the clinical application management of antibacterial drugs according to the characteristics of elderly patients, pregnant women and other key groups, further reflecting the scientific, standardized, professional, refined and information-based management From 2004 to now, the state health and Health Commission has issued 23 notices and methods on antimicrobial drugs on its website Basically every year or two years, it will issue a notice to further strengthen the clinical application management of antimicrobial drugs, which shows the severity of antimicrobial drug abuse Since 2012, the state has taken many measures for the management of antibacterial drugs, including the monitoring of rational use of antibacterial drugs, the construction of antibacterial drug system, the construction of a strong team of experts, and the introduction of the "most stringent anti drug order in history" known as the "management measures for clinical application of antibacterial drugs" Although the introduction of a series of measures has achieved initial results, and the abuse of antibacterial drugs has also improved, according to some clinicians, it is difficult for some hospitals to meet the required inspection standards when using restricted and special use level of antibacterial drugs The infection management department and other departments that regulate the use of antibiotics and other drugs in hospitals have not played a practical role The top-down assessment carried out by the hospital has little effect In this regard, in the notice issued this time, the national health and Health Commission specially pointed out that it is necessary to speed up the construction of multi-disciplinary antibacterial drug management and diagnosis and treatment team, and gradually change the clinical application management of antibacterial drugs from "mainly based on the intervention of administrative departments" to "mainly based on multi-disciplinary professional cooperation management", and change the management thinking There are many reasons for the abuse of antibacterial drugs, among which the improper prescription in the hands of doctors is one of them In February, a new study published by the British public health department pointed out that general practitioners are accelerating the crisis of antibiotic abuse, with as many as 8 million unnecessary antibiotic prescriptions issued by general practitioners every year In order to make the patient's condition better quickly or avoid trouble, some doctors will prescribe antibiotics when they can self heal through resistance, and sometimes prescribe restricted and special use level antibiotics, which accelerates the production of bacterial resistance In response to this problem, the notice clearly pointed out that it is necessary to strictly implement the management of antimicrobial drug classification and doctors' prescription authority, scientifically and reasonably grant different levels of antibacterial drug prescription authority to doctors at different posts according to the needs of different departments and regulations, and effectively play the role of antimicrobial drug classification management In this way, it is more and more difficult for antibiotic manufacturers to do clinical sales The market of antimicrobial agents is not optimistic According to the report on the current situation of antimicrobial drug management and bacterial resistance in China (2017 version) issued by the national health and Family Planning Commission on November 13, 2017, since 2011, the utilization rate and intensity of antimicrobial agents in China have declined, and they have been at a relatively stable level in the past two years According to the report, as of 2016, there were 2671 registered units in the national monitoring network for clinical application of antimicrobial drugs, including 351 member units in the center The average utilization rate of antibacterial drugs of inpatients in the member units of the center decreased from 59.4% in 2011 to 37.5% in 2016, and that of outpatient decreased from 16.2% in 2011 to 8.7% in 2016 In 2016, the utilization rate of antibacterial drugs in the inpatients of the member units of the center decreased by 1.6% compared with 2015, among which the utilization rate of antibacterial drugs in the non operation group decreased by 0.8% compared with 2015, and the utilization rate of antibacterial drugs in the operation group decreased by 2.2% compared with 2015 In 2016, the sales volume of antibiotics and synthetic antibiotics in grade hospitals and retail terminals was 183.1 billion yuan, with a growth rate of 5.8% Among them, the sales volume of antibiotics and synthetic antibiotics in retail pharmacies was 10.841 billion yuan, with a market share of 5.39%, slightly lower than that in 2015 With the further sublimation of the anti microbial order, it can be predicted that the management and use of antibiotics will be more strict in the future, and the survival ability of antibiotics will be more and more difficult.