Unnecessary use of antibiotics for inpatient children with pneumonia in two counties of rural China

Abstract

Objective: To assess unnecessary use and cost of antibiotics for inpatient care for children under 14 years of age with pneumonia, and to identify the cost distribution in relation to different socio-economic status.

Setting: The study was hospital-based and cross-sectional.

Method: Between July 2007 and June 2008, 226 participants were interviewed in two county hospitals and three township health centers in two counties in rural China. The healthcare facilities provided medical and financial records for all study participants. Appropriateness of antibiotic treatment was assessed, in accordance with guidelines, by a paediatrician from a university teaching hospital, who reviewed all medical records. The cost of unnecessary antibiotics was based on the health facilities' price lists.

Results: Unnecessary antibiotic prescriptions occurred in 43% of all patients. The median unnecessary cost of antibiotics was 40 RMB yuan (IQR: 22-100), and this extra cost increased the financial burden for the pneumonia inpatients by 18%. There were no statistically significant differences related to socio-economic categories for unnecessary antibiotics cost (F = 1.43, P = 0.2444).

Conclusion: Unnecessary prescribing of antibiotics use laid an extra burden on children with pneumonia at inpatient care. Implications for policy and practice might be considered regarding incentives, guidelines and training for health care providers.