Antibiotic use in emergency departments of class Ⅲ general hospitals in China / 中华流行病学杂志

ABSTRACT

Objective To investigate the utilization of antibiotics in emergency departments (EDs) of class Ⅲ general hospitals in China.Methods Data from a national monitoring network for rational use of drugs was used.The data included prescriptions of EDs from 114 class Ⅲ general hospitals in 30 provinces (autonomous regions,municipalities) of China.A total of 10 260 595 prescriptions from October 1,2014 to December 31,2016 were extracted.The Anatomical Therapeutic Chemical Classification/Defined Daily Dose (DDD) system was used for the classification of antibiotics and calculation of antibiotic use intensity.An auto-regression model was used to analyze the trend over time and seasonal variation of antibiotic use in EDs.Results The rate of antibiotic prescriptions was 27.82％ in EDs,among the antibiotics prescribed,25.58％ were for the combination therapy with 2 or more antibiotic agents,and injectable antibiotic prescriptions accounted for 60.59％.Besides,the number of DDDs per 100 patient visits was 81.84.Broad-spectrum agents were the most commonly used antibiotics,among which the second and third generation cephalosporins,quinolones and macrolides accounted for 23.83％,21.68％,19.17％ and 7.89％ of all prescribed antibiotics,respectively.The use of antibiotics,including prescription frequency and use intensity,in EDs had a slight but significant increase tendency (P＜0.05),and the seasonal variation of antibiotic use in EDs was obvious,characterized by the highest frequency and intensity of antibiotic use in winter,the differences were significant (P＜0.05).Conclusion The antibiotic prescription rate in EDs of class Ⅲ general hospitals in China was controlled at a low level,but the proportions of broad-spectrum antibiotics and injectable antibiotics were high,and a significant increase trend in antibiotic use in EDs was found.