Antimicrobial Drug Use and Changing Trends From 2021 to 2023—A Case Study of a General Hospital in Sichuan Province

Background

Antibiotic resistance (AR) is a growing concern as a result of the widespread and excessive use of antibiotics. Because of this, China's health authorities have implemented a number of antibiotic control measures, including a requirement that the intensity of antibiotic usage stay within 40.00 DDDs. This study, which used a tertiary general hospital in Sichuan Province as an example, examined the hospital's trend in antibiotic use from 2021 to 2023, the relationship between antibiotic use and hospitalization days and CMI, and the viability of 40.000 DDDs in light of the evolving medical landscape.

Methods

Data were obtained through the hospital information system (HIS) and the hospital DRG system. Boston matrix diagrams were used to find the departments that needed to be focused on control, Cochran-Armitage trend test, and ANOVA to analyze the trends of AUR and antimicrobial use density (AUD) in the hospital over time in the last 3 years and to analyze the factors affecting the changes in antibiotic consumption.

Results

Over the previous 3 years, the hospital's antibiotic use rate varied between 40% and 50%, and its intensity of use varied between 40.000 and 50.000 DDDs, both of which were rather steady. January 2023 had a significant rise, with an AUD of 59.38 DDDs and an AUR of 61.80%. The second quadrant has eight departments. Each department's AUD varied dramatically; neurosurgery saw an increase annually (p < 0.05), abdominal wall surgery and gastrointestinal hernia procedures, obstetrics and gynaecologist, and ophthalmology saw a drop annually (p < 0.05). The average number of preoperative hospitalization days (r = 0.1402, p < 0.01) and the CMI (r = 0.4864, p < 0.001) were strongly connected with the AUD of surgical and nonsurgical departments, respectively.

Conclusions

Hospitals should concentrate on the issue of surgical departments' lengthy preoperative prophylactic medication times. AUD management should also be dynamically modified based on CMI, particularly in departments in the second quadrant (low CMI and high AUD). Furthermore, it is challenging to maintain the hospital AUD target value of 40.00 DDDs under the new medical model, given the decline in hospitalization days of discharged patients and the high prevalence of infectious diseases. It is also unclear whether this target value is still appropriate given the current state of medicine.