Point prevalence survey of antimicrobial use in Chinese hospitals in 2012.

BACKGROUND: In China, several measures have been adopted to decrease unnecessary antimicrobial overuse since 2010. This study aimed to identify characteristics of antimicrobial use in Chinese hospitals after implementing these measures and to explore additional targets for future antimicrobial stewardship. METHODS: In 2012, point prevalence surveys conducted in Chinese hospitals included inpatients who were admitted for at least 24 hours. Details regarding infection, antimicrobial use, and bacterial cultures were recorded. RESULTS: A survey of 786,028 inpatients in 1,313 hospitals included prevalence of health care-associated (3.22%) and community-acquired infections (22.52%); antimicrobial use prevalence (AUP, 38.39%); bacterial culture rate (BCR, 40.16%); and proportions of administration of a single antimicrobial (75.33%), therapeutic (23.16%), prophylactic (11.99%), and therapeutic plus prophylactic (3.24%) AUP rates. Prophylactic AUP rates of hospitals with <300, 300-599, 600-899, and ≥900 beds were 14.23%, 12.45%, 11.45%, and 11.34%, respectively. However, BCRs increased with increasing hospital bed numbers. AUP rates for surgical patients with classes I, II, and III wounds were 45.19%, 68.18%, and 68.47%, respectively. Prophylactic AUP rates for surgical patients decreased with increasing hospital bed numbers. These indices varied among different hospital departments. CONCLUSION: More efforts are needed toward small hospitals, prophylactic antimicrobial use for surgical patients, and departments with low BCRs to optimize the clinical antimicrobial use.