Abstract
Background
Children as a population have high antimicrobial prescribing rates which may lead to high resistance of bacteria according to data from some single-center surveys of antibiotic prescribing rates in China. The acquirement of baseline data of antibiotic prescribing is the basis of developing intervention strategies on inappropriate antimicrobial prescriptions. Few studies show clearly the pattern and detailed information on classes of antibiotics and distribution of indications of antibiotic prescriptions in children in China. This study aims to assess the antibiotic prescribing patterns among children and neonates hospitalized in 18 hospitals in China.
Methods
A 24-hour point prevalence survey on antimicrobial prescribing was conducted in hospitalized neonates and children in China from December 1st, 2016 to February 28th, 2017. Information on the antibiotic use of patients under 18 years of age who were administered one or more on-going antibiotics in the selected wards over a 24-hour period was collected. These data were submitted to the GARPEC (Global Antimicrobial Resistance, Prescribing and Efficacy in Children and Neonates) web-based application (https://pidrg-database.sgul.ac.uk/redcap/). For statistical analysis, Microsoft Excel 2007 and SPSS 22.0 were used.
Results
The antibiotic data were collected in 35 wards in 18 hospitals from 9 provinces. In total, 67.76% (975/1439) of the patients (n = 1439) were given at least one antibiotic, including 58.1% (173/298) of neonates (n = 298) and 70.3% (802/1141) of children (n = 1141). In neonates, the three most frequently prescribed antibiotics were third-generation cephalosporins (41.7%), penicillins plus enzyme inhibitor (23.8%), and carbapenems (11.2%). In children, the three most frequently prescribed antibiotics were third-generation cephalosporins (35.5%), macrolides (23.2%), and penicillins plus enzyme inhibitors (15.9%). The most common indication for antibiotics was proven or probable bacterial lower respiratory tract infection (30.9% in neonates and 66.6% in children).
Conclusions
Antibiotics are commonly prescribed in the Chinese children population. It is likely that the third-generation cephalosporins and macrolides are currently overused in Chinese children. Efforts must be made to ensure safe and appropriate antibiotic prescribing to reduce and prevent the future development of antibiotic resistance.
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Acknowledgements
The authors would like to sincerely thank all the members who participated in this study and the linguistic assistance. The authors thank the GARPEC research group for their support.
Funding
This research was funded by Sanming Project of Medicine in Shenzhen (SZSM201512030), Shenzhen Healthcare Research Project (No. SZLY2018016), and the PENTA Foundation.
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Contributions
All authors contributed equally to this paper. YHY, JSZ, WSZ, YJZ, and JKD were responsible for the study concept and design. YHY organized all hospitals to collect data. JSZ, GL, WSZ, HYS, GL, CAZ, CCL, YQL, YNS, DYT, MJD, CYL, LJL, XYD, PJ, PW, CMZ, and CQW collected the data of antibiotic prescriptions. JSZ contributed to the analysis and interpretation of data and writing of the manuscript. YHY and Mike Sharland revised the manuscript. All authors reviewed and agreed the final manuscript.
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Ethical approval
The ethics committee of Shenzhen Children’s Hospital approved the procedures in this study. The protocol of this study was in accordance with the principles of the Declaration of Helsinki.
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The authors declare that they have no conflict of interest.
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Zhang, JS., Liu, G., Zhang, WS. et al. Antibiotic usage in Chinese children: a point prevalence survey. World J Pediatr 14, 335–343 (2018). https://doi.org/10.1007/s12519-018-0176-0
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DOI: https://doi.org/10.1007/s12519-018-0176-0