Advanced neonatal medicine in China: Is newborn ward capacity associated with inpatient antibiotic usage?

Abstract

Previous surveys of neonatal medicine in China have not collected comprehensive information on antibiotic use in newborns. The goal of the present study was to assess the trends in antibiotic use in inpatient newborns from advanced hospitals in mainland China and to evaluate the contributing factors. We extracted retrospective data on newborn clinical units from a database containing key clinical subspecialty area indicators from provincial or ministerial (Class A level III) hospitals over three consecutive years (2008-2010) and in 25 of 31 provincial districts of mainland China. Fifty-five newborn units were included in the study. The results showed that two thirds (65.7% ± 23.1%) of inpatient newborns were prescribed antibiotic products. Antibiotic use rates were significantly different by newborn ward bed capacity (p = 0.023; 60.6% for d capacity (ficant65.7% ± 23-100 beds group, and 77.1% for (ficant65.7% ± 23.1%) of inpatient newb significantly different by type of hospital, geographic area, admission to physician or nurse ratio, or physician or nurse academic degree. Factors contributing significantly to antibiotic use included ward bed capacity, physician to nurse ratio, average hospital stay, and pneumonia to preterm infant ratio. Our data suggested that the use of antibiotics among inpatient newborns in advanced hospitals in mainland China was prevalent and should be subject to rigorous monitoring, and highlighted the need to explore how newborn ward bed capacity potentially impacts antibiotic use.

Fig 1. The procedure for data collection.

Fig 2. The rates of inpatient antibiotic use for newborns among cities.

The bars illustrated the mean rates of inpatient antibiotic use among the participating hospitals from cities and areas in 2008–2010. Northern China included geographical regions of North China and Northeast China, and Western China included Southwest China and Northwest China.