PLoS ONE (Jan 2015)

Significant reduction of antibiotic consumption and patients' costs after an action plan in China, 2010-2014.

  • Lidao Bao,
  • Rui Peng,
  • Yi Wang,
  • Ruilian Ma,
  • Xianhua Ren,
  • Wenbin Meng,
  • Fusheng Sun,
  • Junxia Fang,
  • Ping Chen,
  • Yang Wang,
  • Qiuhong Chen,
  • Jian Cai,
  • Jian Jin,
  • 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,
  • Wenfei Pan,
  • Qian Ding,
  • Jun Cao,
  • Rupin Liu,
  • Nan Chen,
  • Xuelian Huang,
  • Agula B,
  • Haijun Lyu

DOI
https://doi.org/10.1371/journal.pone.0118868
Journal volume & issue
Vol. 10, no. 3
p. e0118868

Abstract

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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.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.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.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.