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PLoS One. 2015 Mar 13;10(3):e0118868. doi: 10.1371/journal.pone.0118868. eCollection 2015.

Significant reduction of antibiotic consumption and patients' costs after an action plan in China, 2010-2014.

Author information

1
Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
2
Department of Obstetrics, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
3
Department of Pharmacy, People's Hospital, Qingdao, Shandong, China.
4
Department of Pharmacy, The Third People's Hospital, Fuyang, Zhejiang, China.
5
Department of Pharmacy, Central Hospital, Zibo, Shandong, China.
6
Department of Pharmacy, Women and Children's Hospital, Maanshan, Henan, China.
7
Department of Pharmacy, The 175th Military Hospital of the People's Liberation Army, Zhangzhou, Fujian, China.
8
Department of Pharmacy, Fengxian District Psychiatric Center, Shanghai, China.
9
Department of Pharmacy, The Ninth Affiliated People's Hospital of Shanghai Transport University, Shanghai, China.
10
Department of Pharmacy, Tuberculosis Hospital, Zhengzhou, Henan, China.
11
Department of Pharmacy, Women and Children's Hospital, Taiyuan, Shanxi, China.
12
Department of Pharmacy, Women and Children's Hospital, Qingdao, Shandong, China.
13
Department of Pharmacy, The Third Hospital, Wuhan, Hubei, China.
14
Department of Pharmacy, Huli District Women and Children's Hospital, Xiamen, Fujian, China.
15
Department of Emergency, Haici Medical Group, Qingdao, Shandong, China.
16
Department of Pharmacy, Psychiatric Center, Xiamen, Fujian, China.
17
Department of Pharmacy, Beijing Youan Hospital of Capital Medical University, Beijing, China.
18
Department of Pharmacy, Minhang District Psychiatric Center, Shanghai, China.
19
Department of Pharmacy, Dongchangfu District Women and Children's Hospital, Liaocheng, Shandong, China.
20
Department of Pharmacy, Lintong District Chinese Medicine Hospital, Xian, Shanxi, China.
21
Department of Pharmacy, People's Hospital, Chengdu, Sichuan, China.
22
Department of Pharmacy, Women and Children's Hospital, Zhuhai, Guangdong, China.
23
Department of Pharmacy, Buwai Cardiology Hospital, Beijing, China.
24
Department of Pharmacy, Affiliated Children's Hospital of Capital Pediatrics Research Center, Beijing, China.
25
Department of Pharmacy, The Fifth People's Hospital, Suzhou, Zhejiang, China.
26
Department of Pharmacy, Central Hospital, Xinyang, Henan, China.
27
Department of Pharmacy, People's Hospital Affiliated to Southern China Medical University, Zhengzhou, Henan, China.
28
Department of Pharmacy, People's Hospital, Luo County, Guangdong, China.
29
Department of Mongolian Medicine, Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
30
Scientific Research Center, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.

Abstract

INTRODUCTION:

On July 1, 2011, the Chinese government launched a national Action Plan for antibiotic stewardship targeting antibiotic misuse in public hospitals. The aim of this study was to evaluate the impacts of the Action Plan in terms of frequency and intensity of antibiotic utilization and patients costs in public general hospitals.

METHODS:

Administrative pharmacy data from July 2010 to June 2014 were sampled from 65 public general hospitals and divided into three segments: (1) July 2010 to June 2011 as the preparation period; (2) July 2011 to June 2012 as the intervention period; and (3) July 2012 to June 2014 as the assessment period. The outcome measures included (1) antibiotic prescribing rates; (2) intensity of antibiotic consumption; (3) patients costs; and (4) duration of peri-operative antibiotic treatment in clean surgeries of thyroidectomy, breast, hernia, and orthopedic procedures. Longitudinal and cross-sectional analyses were conducted.

RESULTS:

Longitudinal analyses showed significant trend changes in the frequency and intensity of antibiotic consumption, the patients' costs on antibiotics, and the duration of antibiotic treatment received by surgical patients undergoing the 4 clean procedures during the intervention period. Cross-sectional analyses showed that the antibiotic prescribing rates were reduced to 35.3% and 12.9% in inpatient and outpatient settings, that the intensity of antibiotic consumption was reduced to 35.9 DDD/100 bed-days, that patients' costs on antibiotics were reduced significantly, and that the duration of peri-operative antibiotic treatment received by surgical patients undergoing the 4 types of clean procedures decreased to less than 24 hour during the assessment period.

CONCLUSION:

The Action Plan, as a combination of managerial and professional strategies, was effective in reducing the frequency and intensity of antibiotic consumption, patients' costs on antibiotics, and the duration of peri-operative antibiotic treatment in the 4 clean surgeries.

PMID:
25767891
PMCID:
PMC4359138
DOI:
10.1371/journal.pone.0118868
[Indexed for MEDLINE]
Free PMC Article

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