Changes in Chinese policies to promote the rational use of antibiotics

Abstract

Xonghong Xiao and colleagues analyze the challenge of antimicrobial resistance in China. A government strategy to promote rational use of antimicrobials in health care reduced antibiotic sales and percentage of prescriptions for antimicrobials for both hospitalized patients and outpatients, and offers insights to shape future initiatives. Please see later in the article for the Editors' Summary.

Figure 1. Overall trends in prevalence of major antimicrobial-resistant bacteria in Chinese tertiary hospitals in 2000–2011.

The majority of the data were adapted from Mohnarin results, which mostly represent situations involving nosocomial infections in tertiary hospitals. The numbers in circles describe the chronology of major administrative interventions taken by the Chinese Ministry of Health. indicates the issue of “temporary rules for pharmaceutical affairs in healthcare institutions” (2002); indicates the issue of “guidance for the clinical use of antimicrobials” (2004); indicates the issue of “regulations for management of nosocomial infections' (2006); indicates the issue of recommendations for enhancing the prevention and control of multidrug resistant bacterial infections (2008); and indicates the special campaign initiated in 2011. MRSA, methicillin-resistant Staphylococcus aureus; ESBL (+) EC, extended-spectrum β-lactamase-producing Escherichia coli; CPR-REC, ciprofloxacin-resistant E. coli; IMI-R PA, imipenem-resistant Pseudomonas aeruginosa; IMI-R AB, imipenem-resistant Acinetobacter baumannii.

Figure 2. Quarterly sales volume and the proportion of antimicrobial agents sold in 2010–2012 in China.

(A) The sales value of all drugs (blue bars) or antimicrobial agents (pink bars) in millions (M) of US dollars (USD) and the proportion of antimicrobial agents sold (green line). (B) The sales volume of all antimicrobial agents in minimal packaging units (green bars) and the percentage of fluoroquinolones (blue line) or cephalosporin sales (red line). Data were adapted from IMS Research.