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Pattern of Antibiotic Prescriptions in Chinese Children, A Cross-Sectional Survey From 17 Hospitals Located Across 10
Jiaosheng Zhang1, Xiang Ma2, Lanfang Tang3
1Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China.
Insights
Broad-spectrum antibiotic use in Chinese children is high, with 76.3% falling into the World Health Organization
Area of Science:
- Pediatric infectious diseases
- Antimicrobial stewardship
- Public health policy
Background:
- Rising antimicrobial resistance is linked to broad-spectrum antibiotic use.
- Data on antibiotic prescribing patterns in Chinese children are scarce.
- Understanding these patterns is crucial for effective antimicrobial stewardship.
Purpose of the Study:
- To describe antibiotic prescribing patterns in hospitalized Chinese children from 2017 to 2019.
- To analyze prescriptions using the Anatomical Therapeutic Chemical (ATC) classification, WHO's Access, Watch, and Reserve (AWaRe) classification, and China's antibiotic classification system.
Main Methods:
- A 1-day point-prevalence survey was conducted across 17 centers in 10 Chinese provinces.
- Data included 4,982 antibiotic prescriptions for hospitalized children.
- Prescriptions were categorized using ATC, AWaRe, and China classification systems.
Main Results:
- Azithromycin, ceftriaxone, and latamoxef were the most prescribed antibiotics.
- Third-generation cephalosporins constituted 38.4% of prescriptions.
- Under the AWaRe classification, 'Watch' group antibiotics accounted for 76.3% of prescriptions.
- Under China's classification, 53.6% were in the 'Restricted' group and 14.5% in the 'Special' group.
Conclusions:
- A high proportion of 'Watch' and 'Special' group antibiotics were prescribed to children in China.
- The AWaRe and China classifications provide valuable metrics for antibiotic stewardship.
- These classification systems can help monitor and guide antibiotic use in pediatric populations.
Objectives:
Use of Broad-spectrum antibiotics is related closely to increasing antimicrobial resistance. Reports on antibiotic prescriptions for Chinese children were rare. We described the prescribing patterns of antibiotic prescriptions for Chinese children from 2017 to 2019 based on the Anatomical Therapeutic Chemical Classification (ATC classification); the Access, Watch, and Reserve (AWaRe) classification from the World Health Organization (WHO), and the Management of Antibiotic Classification in China.
Methods:
A 1-day point-prevalence survey (PPSs) on antibiotics prescribing for Chinese children was conducted in hospitalized children from 17 centers in 10 Chinese provinces from 1 September 2017 to 30 November 2019.
Results:
A total of 4,982 antibiotic prescriptions for Chinese children were included in the analysis. There were 76 types of antibiotic agents in total, 22 (28.9%) of which accounted for 90% of all antibiotic prescriptions. The top-three antibiotics prescribed for children were azithromycin (684, 13.7%), ceftriaxone (508, 10.2%) and latamoxef (403, 8.1%). Third-generation cephalosporins (1,913, 38.4%) were the most commonly prescribed antibiotic classes. On the basis of the AWaRe classification, the Watch group antibiotics accounted for 76.3% and Access group antibiotics accounted for 12.1% of all antibiotic prescriptions. On the basis of the China classification, we showed that 26.5% of antibiotic prescriptions were in the Unrestricted group, 53.6% in the Restricted group, and 14.5% in the Special group.
Conclusion:
The proportion of antibiotics included in the Watch group and the Special group was high in children in China. The AWaRe classification and China classification for antibiotic prescriptions could be used to supply detailed data for antibiotic stewardship as a simple metric.
