title: Significant reduction of antibiotic consumption and patients' costs after an action plan in China, 2010-2014.
abstract: BACKGROUND
  On July 1, 2011, the Chinese government launched a national Action Plan for antibiotic stewardship targeting antibiotic misuse in public hospitals. The aim of this study was to evaluate the impacts of the Action Plan in terms of frequency and intensity of antibiotic utilization and patients costs in public general hospitals.
  
  
  METHODS
  Administrative pharmacy data from July 2010 to June 2014 were sampled from 65 public general hospitals and divided into three segments: (1) July 2010 to June 2011 as the preparation period; (2) July 2011 to June 2012 as the intervention period; and (3) July 2012 to June 2014 as the assessment period. The outcome measures included (1) antibiotic prescribing rates; (2) intensity of antibiotic consumption; (3) patients costs; and (4) duration of peri-operative antibiotic treatment in clean surgeries of thyroidectomy, breast, hernia, and orthopedic procedures. Longitudinal and cross-sectional analyses were conducted.
  
  
  RESULTS
  Longitudinal analyses showed significant trend changes in the frequency and intensity of antibiotic consumption, the patients' costs on antibiotics, and the duration of antibiotic treatment received by surgical patients undergoing the 4 clean procedures during the intervention period. Cross-sectional analyses showed that the antibiotic prescribing rates were reduced to 35.3% and 12.9% in inpatient and outpatient settings, that the intensity of antibiotic consumption was reduced to 35.9 DDD/100 bed-days, that patients' costs on antibiotics were reduced significantly, and that the duration of peri-operative antibiotic treatment received by surgical patients undergoing the 4 types of clean procedures decreased to less than 24 hour during the assessment period.
  
  
  CONCLUSIONS
  The Action Plan, as a combination of managerial and professional strategies, was effective in reducing the frequency and intensity of antibiotic consumption, patients' costs on antibiotics, and the duration of peri-operative antibiotic treatment in the 4 clean surgeries.
authors.affiliation: Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Lidao
authors.initials: L
authors.lastname: Bao
authors.affiliation: Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Peng
authors.affiliation: Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Ruilian
authors.initials: R
authors.lastname: Ma
authors.affiliation: Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Xianhua
authors.initials: X
authors.lastname: Ren
authors.affiliation: Department of Obstetrics, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Meng
authors.affiliation: Department of Pharmacy, People's Hospital, Qingdao, Shandong, China.
authors.forename: Fusheng
authors.initials: F
authors.lastname: Sun
authors.affiliation: Department of Pharmacy, The Third People's Hospital, Fuyang, Zhejiang, China.
authors.forename: Junxia
authors.initials: J
authors.lastname: Fang
authors.affiliation: Department of Pharmacy, Central Hospital, Zibo, Shandong, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Pharmacy, Women and Children's Hospital, Maanshan, Henan, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Pharmacy, The 175th Military Hospital of the People's Liberation Army, Zhangzhou, Fujian, China.
authors.forename: Qiuhong
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Pharmacy, Fengxian District Psychiatric Center, Shanghai, China.
authors.forename: Jian
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authors.lastname: Cai
authors.affiliation: Department of Pharmacy, The Ninth Affiliated People's Hospital of Shanghai Transport University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Jin
authors.affiliation: Department of Pharmacy, Tuberculosis Hospital, Zhengzhou, Henan, China.
authors.forename: Jinhui
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Pharmacy, Women and Children's Hospital, Taiyuan, Shanxi, China.
authors.forename: Shucheng
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Pharmacy, Women and Children's Hospital, Qingdao, Shandong, China.
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Mo
authors.affiliation: Department of Pharmacy, The Third Hospital, Wuhan, Hubei, China.
authors.forename: Enjing
authors.initials: E
authors.lastname: Zhang
authors.affiliation: Department of Pharmacy, Huli District Women and Children's Hospital, Xiamen, Fujian, China.
authors.forename: Yuerong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Emergency, Haici Medical Group, Qingdao, Shandong, China.
authors.forename: Zhaoxin
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Department of Pharmacy, Psychiatric Center, Xiamen, Fujian, China.
authors.forename: Binbin
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Pharmacy, Beijing Youan Hospital of Capital Medical University, Beijing, China.
authors.forename: Xiujuan
authors.initials: X
authors.lastname: Yue
authors.affiliation: Department of Pharmacy, Minhang District Psychiatric Center, Shanghai, China.
authors.forename: Meijun
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Department of Pharmacy, Dongchangfu District Women and Children's Hospital, Liaocheng, Shandong, China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Pharmacy, Lintong District Chinese Medicine Hospital, Xian, Shanxi, China.
authors.forename: Xinchao
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Pharmacy, People's Hospital, Chengdu, Sichuan, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Bian
authors.affiliation: Department of Pharmacy, Women and Children's Hospital, Zhuhai, Guangdong, China.
authors.forename: Shaoshan
authors.initials: S
authors.lastname: Kong
authors.affiliation: Department of Pharmacy, Buwai Cardiology Hospital, Beijing, China.
authors.forename: Wenfei
authors.initials: W
authors.lastname: Pan
authors.affiliation: Department of Pharmacy, Affiliated Children's Hospital of Capital Pediatrics Research Center, Beijing, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Ding
authors.affiliation: Department of Pharmacy, The Fifth People's Hospital, Suzhou, Zhejiang, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Pharmacy, Central Hospital, Xinyang, Henan, China.
authors.forename: Rupin
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of Pharmacy, People's Hospital Affiliated to Southern China Medical University, Zhengzhou, Henan, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Chen
authors.affiliation: Department of Pharmacy, People's Hospital, Luo County, Guangdong, China.
authors.forename: Xuelian
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Mongolian Medicine, Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Agula
authors.initials: A
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authors.affiliation: Scientific Research Center, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Haijun
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authors.lastname: Lyu
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics*; D002681:China; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000191:economics* / Q000706:statistics & numerical data*; D017850:Economics, Pharmaceutical; D006761:Hospitals / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D059035:Perioperative Period / Q000706:statistics & numerical data; D063487:Prescription Drug Misuse / Q000517:prevention & control; D012044:Regression Analysis
chemical_list: D000900:Anti-Bacterial Agents