Antibiotic utilization and appropriateness assessment of hospitalized patients with influenza and respiratory syncytial virus infections in Zhengzhou City
GUO Jin-xin1, WANG Qian-li1, LIN Li2, ZHANG Hua3, REN Ling-shuang1, CHENG Yi-bing2, ZHANG Tian-chen4, LIANG Lu5, GAO Yan-qiu3, CHEN Qiu-sheng3, JIN Zhi-peng2, LIU Rui-hua3, LIAN Hong-kai3, WANG Jiang-tao2, YU Hong-jie1,6
1. School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China; 2. Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou, Henan 450003, China; 3. Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450007, China; 4. Institute of Infectious Disease Control, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi 330029, China; 5. West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041,China; 6. Shanghai Institute of Infectious Disease and Biosecurity, Shanghai 200032, China
Abstract:Objective To describe the antibiotic prescribing patterns in hospitalized patients with influenza and respiratory syncytial virus (RSV) infections in Zhengzhou City, Henan Province, and to assess the appropriateness. Methods A prospective case-series study was conducted from November 2018 to November 2019. We enrolled hospitalizedchildren and adultswith acute respiratory infection in Henan Children’s Hospital and Zhengzhou Central Hospital, and collected demographic andclinical data. Influenza and RSV infections were confirmed by real-time PCR with respiratory tract specimens collected. Influenza and RSV infections complicated with bacterial infection, antibiotic utilization and the appropriateness were analyzed. Results A total of 669 hospitalized patients with influenza and RSV infections were detected. Bacterial coinfection was determined in 252 (38.4%, 252/656) hospitalized patients. Coinfection status could not be determined in 13 hospitalized patients. 97.9% of the hospitalized patients received antibiotics during hospitalization. Third-generation cephalosporins (77.0%), macrolides (20.3%), combinations of penicillins with beta-lactamase inhibitor (15.5%), quinolones (9.9%) and carbapenems (7.9%) were the antibiotic types frequently prescribed. The interval from admission to antibiotic administration was 1.0 (1.0, 1.0) day and duration of the treatment was 6.0 (5.0, 8.0) days. The consumption and cost of antibiotics was 2.4 (1.3, 6.0) DDDs and 369.7 (210.6, 1,154.0) CNY per person, respectively. Of the 655 influenza and RSV patients with antibiotic prescriptions, 37.7% received appropriate regimens and 60.3% inappropriate regimens. Conclusion The study reveals extensive antibiotic utilization with heavy cost burden among the hospitalized patients with influenza and RSV infections in Zhengzhou City. Inappropriate antibiotic prescriptions without indication or for preventive treatment are prevalent; and hence, antibiotic supervision still needs to be strengthened.
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