Related Experiment Video
Updated: Nov 9, 2025
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Antibiotic Use Among Hospitalized Children and Neonates in China: Results From Quarterly Point Prevalence Surveys in
Chu-Ning Wang1, Jianning Tong2, Bin Yi3
1Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China.
Insights
Overuse of broad-spectrum antibiotics in Chinese pediatric hospitals is common, with 70.4% of prescriptions from the WHO Watch group. Routine surveillance using WHO AWaRe metrics is recommended to guide interventions.
Area of Science:
- Pediatric infectious disease
- Antimicrobial stewardship
- Public health surveillance
Background:
- Antimicrobial resistance poses a significant challenge in pediatric care in China.
- Antibiotic use surveillance is crucial for evaluating prescribing quality and guiding stewardship interventions.
Purpose of the Study:
- To assess antibiotic use patterns in pediatric inpatients in China using WHO AWaRe metrics.
- To identify areas for improvement in antibiotic stewardship.
Main Methods:
- Quarterly point prevalence surveys conducted in 16 Chinese hospitals in 2019.
- Data collected from hospital information systems on antibiotic prescriptions for pediatric inpatients.
- Analysis of prescribing patterns based on WHO AWaRe metrics and Anatomical Therapeutic Chemical (ATC) Classification.
Main Results:
- 66.1% of 22,327 pediatric inpatients received antibiotics; 59.2% of neonates received antibiotics.
- High rates of combination antibiotic therapy were observed in PICUs (78.5%) and other wards.
- WHO Watch group antibiotics comprised 70.4% of prescriptions, with third-generation cephalosporins being most common.
Conclusions:
- Broad-spectrum Watch group antibiotic overuse is prevalent in Chinese pediatric inpatients.
- Targeted interventions are needed to reduce Watch antibiotic use within the national stewardship framework.
- Routine surveillance using WHO AWaRe metrics should be implemented for ongoing monitoring.
Abstract:
Background: Antimicrobial resistance is a significant clinical problem in pediatric practice in China. Surveillance of antibiotic use is one of the cornerstones to assess the quality of antibiotic use and plan and assess the impact of antibiotic stewardship interventions. Methods: We carried out quarterly point prevalence surveys referring to WHO Methodology of Point Prevalence Survey in 16 Chinese general and children's hospitals in 2019 to assess antibiotic use in pediatric inpatients based on the WHO AWaRe metrics and to detect potential problem areas. Data were retrieved via the hospital information systems on the second Monday of March, June, September and December. Antibiotic prescribing patterns were analyzed across and within diagnostic conditions and ward types according to WHO AWaRe metrics and Anatomical Therapeutic Chemical (ATC) Classification. Results: A total of 22,327 hospitalized children were sampled, of which 14,757 (66.1%) were prescribed ≥1 antibiotic. Among the 3,936 sampled neonates (≤1 month), 59.2% (n = 2,331) were prescribed ≥1 antibiotic. A high percentage of combination antibiotic therapy was observed in PICUs (78.5%), pediatric medical wards (68.1%) and surgical wards (65.2%). For hospitalized children prescribed ≥1 antibiotic, the most common diagnosis on admission were lower respiratory tract infections (43.2%, n = 6,379). WHO Watch group antibiotics accounted for 70.4% of prescriptions (n = 12,915). The most prescribed antibiotic ATC classes were third-generation cephalosporins (41.9%, n = 7,679), followed by penicillins/β-lactamase inhibitors (16.1%, n = 2,962), macrolides (12.1%, n = 2,214) and carbapenems (7.7%, n = 1,331). Conclusion: Based on these data, overuse of broad-spectrum Watch group antibiotics is common in Chinese pediatric inpatients. Specific interventions in the context of the national antimicrobial stewardship framework should aim to reduce the use of Watch antibiotics and routine surveillance of antibiotic use using WHO AWaRe metrics should be implemented.
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:29Drug Dosing: Infants and Children
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
00:57Antibiotic Selection