| Title | Appropriateness of Antibiotic Prescriptions in Chinese Primary Health Care and the Impact of the COVID-19 Pandemic: A Typically Descriptive and Longitudinal Database Study in Yinchuan City |
| Authors | Zhao, Houyu Wang, Shengfeng Meng, Ruogu Liu, Guozhen Hu, Jing Zhang, Huina Yan, Shaohua Zhan, Siyan |
| Affiliation | Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing, Peoples R China Peking Univ, Natl Inst Hlth Data Sci, Beijing, Peoples R China Peking Univ Hlth Informat Technol, Beijing, Peoples R China Capital Med Univ, Beijing Inst Tradit Chinese Med, Beijing Hosp Tradit Chinese Med, Beijing, Peoples R China Beijing Univ Chinese Med, Dongfang Hosp, Dept Oncol, Beijing, Peoples R China Peking Univ Third Hosp, Res Ctr Clin Epidemiol, Beijing, Peoples R China Peking Univ, Inst Artificial Intelligence, Ctr Intelligent Publ Hlth, Beijing, Peoples R China |
| Keywords | ANTIMICROBIAL RESISTANCE CONSUMPTION EPIDEMIOLOGY SURVEILLANCE |
| Issue Date | 14-Apr-2022 |
| Publisher | FRONTIERS IN PHARMACOLOGY |
| Abstract | Background: The appropriateness of antibiotic prescriptions in primary care has not been well evaluated in China in recent years. Furthermore, the impact of coronavirus disease 2019 (COVID-19) on antibiotic prescriptions has not yet been investigated in China. We aimed to assess the appropriateness of antibiotic prescriptions and to evaluate the potential association between the COVID-19 pandemic and antibiotic prescriptions in primary care settings of Yinchuan, a city in China.Methods: This study included 155 primary care institutions and 10,192,713 outpatient visits. Outpatient prescriptions were classified as appropriate, potentially appropriate, inappropriate, or not linked to any diagnosis for antibiotic use following a validated evaluation scheme. Interrupted time-series analyses were performed to assess the effects of the COVID-19 pandemic on antibiotic prescriptions in Chinese primary care facilities.Results: During the study period, 1,287,678 (12.6%, 95% confidence interval [12.6-12.7]) of 10,192,713 outpatient visits in primary care resulted in antibiotic prescriptions. Among 1,287,678 antibiotic prescriptions, 653,335 (50.7% [50.6-50.9]) were inappropriate, 463,081 (36.0% [35.8-36.1]) were potentially appropriate, 171,056 (13.3% [13.1-13.5]) were appropriate, and 206 could not be linked to any diagnosis. Furthermore, patient, physician, and institutional factors were associated with inappropriate antibiotic prescriptions; there was an overall decreasing trend in the proportions of inappropriate antibiotic prescriptions, with the highest level in 2017 (67.1% [66.8-67.5]) and the lowest in 2021 (40.8% [40.3-41.3]). A total of 1,416,120 individual antibiotics were prescribed, of which 1,087,630 (76.8%) were broad-spectrum and 777,672 (54.9%) were classified in the World Health Organization's "Watch" category. In addition, the COVID-19 pandemic was associated with changes of -2.8% (-4.4 to -1.3) in the level and 0.3% (0.2-0.3) in the monthly trend of antibiotic prescription rates, as well as changes of -5.9% (-10.2 to -1.5) in the level and 1.3% (1.0-1.6) in the monthly trend of the proportions of inappropriate antibiotic prescriptions.Conclusion: More than half of the antibiotic prescriptions were inappropriate during the study period in primary care in Yinchuan. The COVID-19 pandemic may be associated with a decrease in the overall and inappropriate use of antibiotics in primary care settings in China. |
| URI | http://hdl.handle.net/20.500.11897/643474 |
| DOI | 10.3389/fphar.2022.861782 |
| Indexed | SCI(E) |
| Appears in Collections: | 公共卫生学院 第三医院 |
