Interrupted time-series analysis to evaluate the impact of a national antimicrobial stewardship campaign on antibiotic use among primary healthcare institutions: evidence from Central China.

Abstract

Objective: Antimicrobial resistance (AMR) is a global health challenge, highlighting the need for antibiotic stewardship policies. We evaluated the impact of the National Action Plan to Contain Antimicrobial Resistance (2022-2025) on antibiotic use among primary healthcare institutions (PHIs) in Central China.

Design: A segmented interrupted time-series analysis from January 2021 to December 2023.

Methods: We collected data from 1510 PHIs, by region, types of healthcare institutions and medication type, assessing antibiotic consumption using defined daily doses per 1000 inhabitants per day and the quality by the percentage of broad-spectrum antibiotics.

Results: Post-intervention, antibiotic consumption declined by -35.96% (95%CI: -49.34 to -22.57), and the proportion of broad-spectrum antibiotic use decreased by -41.97% (-61.74 to -22.20). Consumption dropped significantly in both moderately developed areas and underdeveloped areas, while highly developed areas saw the largest reduction in broad-spectrum antibiotic use. Rural PHIs also showed notable declines in both overall antibiotic consumption and broad-spectrum usage.

Conclusions: The policy was associated with a reduction in antibiotic use across PHIs, though regional disparities in its implementation suggest uneven benefits.