Antibiotic prescribing practices in secondary and tertiary hospitals in Shaanxi province, western China, 2013-2015.

INTRODUCTION: The irrational use of antibiotics is a major driver of antimicrobial resistance. This study aimed to explore how antibiotics were used in secondary and tertiary hospitals in Shaanxi Province, western China from 2013 to 2015.

METHOD: A retrospective study was conducted with a sample of 16 hospitals in Shaanxi Province (2 tertiary and 14 secondary hospitals; 8 public and 8 private hospitals) using a stratified random sampling method. All of the macro data from these hospitals from 2013 to 2015 were analyzed. All collected data were double-entered and analyzed using Excel 2007.

RESULTS: The percentage of injectable antibiotic prescriptions was 26.6% of all of the antibiotic prescriptions in the secondary hospitals and 14.2% in the tertiary hospitals. Injectable antibiotic prescriptions in private tertiary hospitals (enter %) were more than two times that of public tertiary hospitals (enter %). In both tertiary and secondary hospitals, the percentage of antibiotic prescriptions for outpatients, emergency patients and inpatients were within the scope of the national standards, while the intensity of antibiotic use was higher than the national standard of 40 DDD/100 bed-days. The prophylactic antibiotic use rate in clean surgery was 40.4% in tertiary hospitals and 60.7% in secondary hospitals, which were both higher than the national standard of 30%. The preventive use rate of antibiotics in private tertiary hospitals (55.00%) was more than two times that of public tertiary hospitals (25.90%), and the rate was also higher in private secondary hospitals (61.50%) than in public secondary hospitals (59.70%).

CONCLUSIONS: Substantial antibiotic abuse occurred in the sample Chinese hospitals, especially in secondary hospitals. The government should continue to strengthen the administration of antimicrobial use in hospitals. At the same time, medical professional training and interventions for physicians should be conducted to fundamentally reduce the irrational use of antibiotics.