Pattern of Antibiotic Prescriptions in Chinese Children, A Cross-Sectional Survey From 17 Hospitals Located Across 10 Provinces of China

Jiaosheng Zhang; Xiang Ma; Lanfang Tang; Daiyin Tian; Li Lin; Yanqi Li; Gen Lu; Ligang Si; Wenshuang Zhang; Jing Qian; Lijuan Wu; Gang Liu; Wei Li; Qing Cao; Keye Wu; Yuejie Zheng; Jikui Deng; Yonghong Yang

doi:10.3389/fped.2022.857945

Pattern of Antibiotic Prescriptions in Chinese Children, A Cross-Sectional Survey From 17 Hospitals Located Across 10 Provinces of China

Front Pediatr. 2022 Jul 14:10:857945. doi: 10.3389/fped.2022.857945. eCollection 2022.

Authors

Jiaosheng Zhang¹, Xiang Ma², Lanfang Tang³, Daiyin Tian⁴, Li Lin⁵, Yanqi Li⁶, Gen Lu⁷, Ligang Si⁸, Wenshuang Zhang⁹, Jing Qian¹⁰, Lijuan Wu¹¹, Gang Liu¹², Wei Li¹³, Qing Cao¹⁴, Keye Wu¹⁵, Yuejie Zheng¹⁶, Jikui Deng¹, Yonghong Yang¹⁷

Affiliations

¹ Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China.
² Department of Respiratory, Jinan Children's Hospital and Children's Hospital Affiliated to Shandong University, Jinan, China.
³ Department of Respiratory, Children's Hospital Zhejiang University School of Medicine, Hangzhou, China.
⁴ Department of Respiratory, Children's Hospital of Chongqing Medical University, Chongqing, China.
⁵ Department of Respiratory, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
⁶ Department of Respiratory, Xi'an Children's Hospital, Xi'An, China.
⁷ Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou, China.
⁸ Department of Respiratory, The First Hospital of Haerbin Medical University, Harbin, China.
⁹ Department of Respiratory, Tianjin Children's Hospital, Tianjin, China.
¹⁰ Department of Respiratory, Children's Hospital Attached to The Capital Institute of Pediatrics, Beijing, China.
¹¹ Clinical Laboratory, Bao'an Maternity and Child Health Hospital, Shenzhen, China.
¹² Department of Infectious Diseases, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, China.
¹³ Department of Pediatric Respiratory, The First Hospital of Jilin University, Changchun, China.
¹⁴ Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁵ Department of Cardiothoracic Surgery, Shenzhen Children's Hospital, Shenzhan, China.
¹⁶ Department of Respiratory, Shenzhen Children's Hospital, Shenzhen, China.
¹⁷ Beijing Pediatric Research Institute, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Department of Internal Medicine, Shenzhen Children's Hospital, Beijing, China.

Abstract

Objectives: Use of Broad-spectrum antibiotics is related closely to increasing antimicrobial resistance. Reports on antibiotic prescriptions for Chinese children were rare. We described the prescribing patterns of antibiotic prescriptions for Chinese children from 2017 to 2019 based on the Anatomical Therapeutic Chemical Classification (ATC classification); the Access, Watch, and Reserve (AWaRe) classification from the World Health Organization (WHO), and the Management of Antibiotic Classification in China.

Methods: A 1-day point-prevalence survey (PPSs) on antibiotics prescribing for Chinese children was conducted in hospitalized children from 17 centers in 10 Chinese provinces from 1 September 2017 to 30 November 2019.

Results: A total of 4,982 antibiotic prescriptions for Chinese children were included in the analysis. There were 76 types of antibiotic agents in total, 22 (28.9%) of which accounted for 90% of all antibiotic prescriptions. The top-three antibiotics prescribed for children were azithromycin (684, 13.7%), ceftriaxone (508, 10.2%) and latamoxef (403, 8.1%). Third-generation cephalosporins (1,913, 38.4%) were the most commonly prescribed antibiotic classes. On the basis of the AWaRe classification, the Watch group antibiotics accounted for 76.3% and Access group antibiotics accounted for 12.1% of all antibiotic prescriptions. On the basis of the China classification, we showed that 26.5% of antibiotic prescriptions were in the Unrestricted group, 53.6% in the Restricted group, and 14.5% in the Special group.

Conclusion: The proportion of antibiotics included in the Watch group and the Special group was high in children in China. The AWaRe classification and China classification for antibiotic prescriptions could be used to supply detailed data for antibiotic stewardship as a simple metric.

Keywords: AWaRe classification; China; antibiotic; children; inpatients; pattern.