Open AccessSignificant Reduction of Antibiotic Consumption and Patients’ Costs after an Action Plan in China, 2010–2014
Author(s) -
Bao Liu,
Rui Peng,
Yi Wang,
Ruilian Ma,
Xianhua Ren,
Weizhen Meng,
Fei Sun,
Junxia Fang,
Ping Chen,
Yan Wang,
Qiuhong Chen,
Jianwei Cai,
Jinbao Jian,
Jinhui Guo,
Shucheng Yang,
Xiaomei Mo,
Enjing Zhang,
Yuerong Zhang,
Zhaoxin Lu,
Binbin Chen,
Xiujuan Yue,
MeiJun Zhu,
Yingying Wang,
Xinchao Li,
Yuan Bian,
Shaoshan Kong,
Wenping Pan,
Qian Ding,
Jun Cao,
Rupin Liu,
Nan Chen,
Xuelian Huang,
B Agula,
Haijun Lyu
Publication year - 2015
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0118868
Subject(s) - china , consumption (sociology) , antibiotics , reduction (mathematics) , action plan , medicine , biology , microbiology and biotechnology , geography , ecology , social science , geometry , mathematics , archaeology , sociology
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.