Pediatric Antibiotic Prescribing in China According to the 2019 World Health Organization Access, Watch, and Reserve (AWaRe) Antibiotic Categories.

To assess clinical indication-specific antibiotic prescribing in pediatric practice in China based on the World Health Organization (WHO) Access, Watch, and Reserve (AWaRe) metrics and to detect potential problem areas. Pediatric prescription records on the 16th of each month during 2018 were sampled for all encounters at outpatient and emergency departments of 16 tertiary care hospitals via hospital information systems. Antibiotic prescribing patterns were analyzed across and within diagnostic conditions according to WHO AWaRe metrics and Anatomical Therapeutic Chemical (ATC) classification. A total of 260 001 pediatric encounters were assessed, and antibiotics were prescribed in 94 453 (36.3%). In 35 167 encounters (37.2%), at least 1 intravenous antibiotic was administered. WHO Watch group antibiotics accounted for 82.2% (n = 84 176) of all antibiotic therapies. Azithromycin (n = 15 791; 15.4%) was the most commonly prescribed antibiotic, and third-generation cephalosporins (n = 44 387; 43.3%) were the most commonly prescribed antibiotic class. In at least 66 098 encounters (70.0%), antibiotics were prescribed for respiratory tract conditions, mainly for bronchitis/bronchiolitis (n = 25 815; 27.3%), upper respiratory tract infection (n = 25 184; 26.7%), and pneumonia (n = 13 392; 14.2%). Overuse and misuse of WHO Watch group antibiotics for respiratory tract conditions and viral infectious diseases is common in pediatric outpatients in China. Pediatric antimicrobial stewardship should be strengthened using WHO AWaRe metrics. Copyright © 2020 Elsevier Inc. All rights reserved.

Citation

Chu-Ning Wang, Benedikt D Huttner, Nicola Magrini, Yibing Cheng, Jianning Tong, Shuangjie Li, Chaomin Wan, Qingxiong Zhu, Shiyong Zhao, Zhiqiang Zhuo, Daojiong Lin, Bin Yi, Qingwen Shan, Mei Long, Chunmei Jia, Dongchi Zhao, Xiaofeng Sun, Juan Liu, Yibo Zhou, Rui Li, Jing Liu, Yu Zhu, Ruixue Miao, Chunhui Zhu, Zhenghong Qi, Caihong Wang, Shouye Wu, Xiaohong Xu, Li Zhou, Wenyu Ye, Na Luo, Huiling Gao, Pu Yang, Maihebuba Bieerding, Jie Tang, Mei Zeng, Collaborative Working Group of the Pediatric Subgroup of the China Society of Infectious Diseases. Pediatric Antibiotic Prescribing in China According to the 2019 World Health Organization Access, Watch, and Reserve (AWaRe) Antibiotic Categories. The Journal of pediatrics. 2020 May;220:125-131.e5

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PMID: 32093934

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