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Article

Analysis of Antibiotic Use Patterns and Trends Based on Procurement Data of Healthcare Institutions in Shaanxi Province, Western China, 2015–2018

by 1,2,3,4, 1,2,3,4, 1,2,3,4, 1,2,3,4, 1,2,3,4, 1,2,3,4,* and 1,2,3,4,*
1
Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710000, China
2
Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710000, China
3
Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710000, China
4
Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an 710000, China
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(20), 7536; https://doi.org/10.3390/ijerph17207536
Received: 10 September 2020 / Revised: 10 October 2020 / Accepted: 14 October 2020 / Published: 16 October 2020
Overuse of antibiotics has caused a series of global problems, especially in the underdeveloped western regions where healthcare systems are fragile. We used antibiotic procurement data of all healthcare institutions to analyze the total amount, patterns and trends of antibiotic use in Shaanxi Province, western China between 2015 and 2018. Antibiotic utilization was quantified using the standard Anatomical Therapeutic Chemical (ATC)/Defined daily dose (DDD) methodology. The World Health Organization’s “Access, Watch and Reserve” (AWaRe) classification and European Surveillance of Antimicrobial Consumption (ESAC) drug-specific quality indicators were also adopted to evaluate the appropriateness and quality of antibiotic utilization. Overall, antibiotic consumption decreased from 11.20 DID in 2015 to 10.13 DID (DDDs per 1000 inhabitants per day) in 2016, then increased to 12.99 DID in 2018. The top three antibiotic categories consumed in 2018 were J01C (penicillins) 33.58%, J01D (cephalosporins) 29.76%, and J01F (macrolides) 19.14%. Parenteral antibiotics accounted for 27.41% of the total consumption. The largest proportion of antibiotic use was observed in primary healthcare institutions in rural areas, which accounts for 51.67% of total use. Consumption of the Access group, the Watch group, the Reserve group of antibiotics was 40.31%, 42.28% and 0.11%, respectively. Concurrently, the consumption of J01D and the percentage of J01 (DD + DE) (third and fourth generation cephalosporins) were at a poor level according to the evaluation of ESAC quality indicators. The total antibiotic consumption in Shaanxi Province had been on an upward trend, and the patterns of antibiotic use were not justified enough to conclude that it was rational. This is partly because there was high preference for the third and fourth generation cephalosporins and for the Watch group antibiotics. View Full-Text
Keywords: trends and patterns; antibiotic utilization; healthcare institutions; west China trends and patterns; antibiotic utilization; healthcare institutions; west China
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MDPI and ACS Style

Xu, S.; Yuan, S.; Kabba, J.A.; Chen, C.; Liu, W.; Chang, J.; Fang, Y. Analysis of Antibiotic Use Patterns and Trends Based on Procurement Data of Healthcare Institutions in Shaanxi Province, Western China, 2015–2018. Int. J. Environ. Res. Public Health 2020, 17, 7536. https://doi.org/10.3390/ijerph17207536

AMA Style

Xu S, Yuan S, Kabba JA, Chen C, Liu W, Chang J, Fang Y. Analysis of Antibiotic Use Patterns and Trends Based on Procurement Data of Healthcare Institutions in Shaanxi Province, Western China, 2015–2018. International Journal of Environmental Research and Public Health. 2020; 17(20):7536. https://doi.org/10.3390/ijerph17207536

Chicago/Turabian Style

Xu, Sen, Shengfang Yuan, John A. Kabba, Chen Chen, Wenchen Liu, Jie Chang, and Yu Fang. 2020. "Analysis of Antibiotic Use Patterns and Trends Based on Procurement Data of Healthcare Institutions in Shaanxi Province, Western China, 2015–2018" International Journal of Environmental Research and Public Health 17, no. 20: 7536. https://doi.org/10.3390/ijerph17207536

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