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

Bao L, Peng R, Wang Y, Ma R, Ren X, Meng W, Sun F, Fang J, Chen P, Wang Y, Chen Q, Cai J, Jin J, Guo J, Yang S, Mo X, Zhang E, Zhang Y, Lu Z, Chen B, Yue X, Zhu M, Wang Y, Li X, Bian Y, Kong S, Pan W, Ding Q, Cao J, Liu R, Chen N, Huang X, B A, Lyu H - PLoS ONE (2015)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.

ABSTRACT

Introduction: 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.

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Related in: MedlinePlus

Changes in antibiotic prescribing rates and intensity of antibiotic consumption.Time series of average monthly value of the antibiotic prescribing rates (A) were plotted for inpatient (IN), outpatient (OUT), and emergency (EM) settings. The data on intensity of antibiotic consumption were plotted for the inpatient (B) and outpatient settings (C). Cross-sectional analyses were conducted by comparing the average yearly data on antibiotic prescribing rates in inpatient (D), outpatient (E) and emergency (F) settings as well as the intensity of consumption in the inpatient (G) and outpatient (H) settings. P: preparation; I: intervention; A: assessment; *significant difference in intervention/assessment vs. preparation; #significant difference in assessment vs. intervention.
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pone.0118868.g001: Changes in antibiotic prescribing rates and intensity of antibiotic consumption.Time series of average monthly value of the antibiotic prescribing rates (A) were plotted for inpatient (IN), outpatient (OUT), and emergency (EM) settings. The data on intensity of antibiotic consumption were plotted for the inpatient (B) and outpatient settings (C). Cross-sectional analyses were conducted by comparing the average yearly data on antibiotic prescribing rates in inpatient (D), outpatient (E) and emergency (F) settings as well as the intensity of consumption in the inpatient (G) and outpatient (H) settings. P: preparation; I: intervention; A: assessment; *significant difference in intervention/assessment vs. preparation; #significant difference in assessment vs. intervention.

Mentions: The impacts of the Action Plan on antibiotic consumption in the 65 general hospitals are shown in Fig. 1. The changes of level and trend with respects to antibiotic prescribing rates during the preparation, intervention, and assessment periods are summarized in Table 1. Fig. 1A shows that the average antibiotic prescribing rates declined by 2.27% (se = 0.22; p < 0.001), by 1.07% (se = 0.37; p = 0.004), and by 1.31% (se = 0.19; p < 0.001) per month in the inpatient, outpatient and emergency settings during the intervention period, respectively (Table 1). Cross-sectional analyses showed that the average prescribing rate was reduced significantly from 62.9% during the preparation period to 35.3% during the assessment period in the inpatient settings (p < 0.001; Fig. 1D). Similar reductions in prescribing rates were observed in both outpatient (26.4% vs. 12.9%; p < 0.001) and emergency (44.2% vs. 28.4%; p < 0.001) settings during the assessment period compared with the preparation period (Fig. 1E and 1F).


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

Bao L, Peng R, Wang Y, Ma R, Ren X, Meng W, Sun F, Fang J, Chen P, Wang Y, Chen Q, Cai J, Jin J, Guo J, Yang S, Mo X, Zhang E, Zhang Y, Lu Z, Chen B, Yue X, Zhu M, Wang Y, Li X, Bian Y, Kong S, Pan W, Ding Q, Cao J, Liu R, Chen N, Huang X, B A, Lyu H - PLoS ONE (2015)

Changes in antibiotic prescribing rates and intensity of antibiotic consumption.Time series of average monthly value of the antibiotic prescribing rates (A) were plotted for inpatient (IN), outpatient (OUT), and emergency (EM) settings. The data on intensity of antibiotic consumption were plotted for the inpatient (B) and outpatient settings (C). Cross-sectional analyses were conducted by comparing the average yearly data on antibiotic prescribing rates in inpatient (D), outpatient (E) and emergency (F) settings as well as the intensity of consumption in the inpatient (G) and outpatient (H) settings. P: preparation; I: intervention; A: assessment; *significant difference in intervention/assessment vs. preparation; #significant difference in assessment vs. intervention.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4359138&req=5

pone.0118868.g001: Changes in antibiotic prescribing rates and intensity of antibiotic consumption.Time series of average monthly value of the antibiotic prescribing rates (A) were plotted for inpatient (IN), outpatient (OUT), and emergency (EM) settings. The data on intensity of antibiotic consumption were plotted for the inpatient (B) and outpatient settings (C). Cross-sectional analyses were conducted by comparing the average yearly data on antibiotic prescribing rates in inpatient (D), outpatient (E) and emergency (F) settings as well as the intensity of consumption in the inpatient (G) and outpatient (H) settings. P: preparation; I: intervention; A: assessment; *significant difference in intervention/assessment vs. preparation; #significant difference in assessment vs. intervention.
Mentions: The impacts of the Action Plan on antibiotic consumption in the 65 general hospitals are shown in Fig. 1. The changes of level and trend with respects to antibiotic prescribing rates during the preparation, intervention, and assessment periods are summarized in Table 1. Fig. 1A shows that the average antibiotic prescribing rates declined by 2.27% (se = 0.22; p < 0.001), by 1.07% (se = 0.37; p = 0.004), and by 1.31% (se = 0.19; p < 0.001) per month in the inpatient, outpatient and emergency settings during the intervention period, respectively (Table 1). Cross-sectional analyses showed that the average prescribing rate was reduced significantly from 62.9% during the preparation period to 35.3% during the assessment period in the inpatient settings (p < 0.001; Fig. 1D). Similar reductions in prescribing rates were observed in both outpatient (26.4% vs. 12.9%; p < 0.001) and emergency (44.2% vs. 28.4%; p < 0.001) settings during the assessment period compared with the preparation period (Fig. 1E and 1F).

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.

ABSTRACT

Introduction: 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.

Show MeSH
Related in: MedlinePlus