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In their interesting article, Yan Li contended that misuse of antibiotics is a serious public health problem in China, since its rate of antibiotic use for inpatients and outpatients is high. Indeed, stewardship of antimicrobial use was rather feeble in mainland China before 2000, however, China committed to decrease the improper use of antimicrobials since then. 1 2 A surveillance network of antimicrobial use based on the National Healthcare associated Infection Surveillance System (NHAISS) was set up in 2001. 1 Also the health care authority releasing several sets of guidelines and to promote rational use, including principles for clinical use of antibiotics (2004), 3 and national special rectification scheme for clinical use of antimicrobial (annually since 2011). 4 Moreover, administrative regulations for clinical use of antibacterial agents, the law mentioned in the article, which is considered to be the most strict rule for antimicrobials prescription, has been implemented since 1st August, 2012. 2
According to NHAISS, antimicrobial use prevalence (AUP) of inpatients was 56.93% (58063/101991) in 2001 in the point prevalence survey, and it decrease to 54.86% (49123/89523), 48.42% (55752/115143), 47.69% (79989/167740), 49.63(202085/407208) and 38.39% (301770/786028) in 2003, 2005, 2008, 2010 and 2012 respectively. 5 6 The proportion of administration of a single antimicrobial increased significantly (59.52% in 2001, 67.96% in 2010, 75.33% in 2012), 5 on the contrary, the proportion of antimicrobial used for combination therapy decreased. AUP of surgical patients declined form 76.78% (66309/86360) in 2010 to 59.14% (66309/86360, latest data) in 2012. In brief, though there are many problems, regarding antibiotics use and drug resistance, remaining to be solved, the rational use of antibiotics has improved notably after above measures were adopted in China in recent years, especially after 2010.
Pengcheng Zhou, Chunhui Li, Anhua Wu*
Infection Control Center, Xiangya Hospital, Central South University, Changsha, 410008, China.
*Corresponding author, E-mail address: xywuanhua@csu.edu.cn (Anhua Wu)
There is no conflict of interest with the article.
References:
1. Li C, Ren N, Wen X, Zhou P, Huang X, et al. Changes in Antimicrobial Use Prevalence in China:Results from Five Point Prevalence Studies. PLoS One 2013;12(8):e82785.
2. Xiao Y, Li L. Legislation of clinical antibiotic use in China. Lancet Infect Dis 2013;13(3):189-91.
3. Ministry Of Health, China. Principles for clinical use of antibiotics, 2004. http://www.moh.gov.cn/mohyzs/s3573/200804/18544.shtml
4. Ministry Of Health, China. National special rectification scheme for clinical use of antimicrobial in 2011, 2011. http://www.gdwst.gov.cn/a/zcdt/201105278814.html
5. Li C, Wu A, Wen X, Ren N. National health care-associated infection surveillance system point-prevalence trend of antibacterial use in Chinese hospitals 2001-2012. Chin J Nosocomiol 2012;22(21):4859-4861.
6. Wu A, Wen X, Li C, Ren N, Gong R, Huang X, et al. China national point prevalance survey on healthcare-associated infection and antimicrobial use in 2012. Chin J Infect control 2014(01):8-15.
Re: China’s misuse of antibiotics should be curbed
In their interesting article, Yan Li contended that misuse of antibiotics is a serious public health problem in China, since its rate of antibiotic use for inpatients and outpatients is high. Indeed, stewardship of antimicrobial use was rather feeble in mainland China before 2000, however, China committed to decrease the improper use of antimicrobials since then. 1 2 A surveillance network of antimicrobial use based on the National Healthcare associated Infection Surveillance System (NHAISS) was set up in 2001. 1 Also the health care authority releasing several sets of guidelines and to promote rational use, including principles for clinical use of antibiotics (2004), 3 and national special rectification scheme for clinical use of antimicrobial (annually since 2011). 4 Moreover, administrative regulations for clinical use of antibacterial agents, the law mentioned in the article, which is considered to be the most strict rule for antimicrobials prescription, has been implemented since 1st August, 2012. 2
According to NHAISS, antimicrobial use prevalence (AUP) of inpatients was 56.93% (58063/101991) in 2001 in the point prevalence survey, and it decrease to 54.86% (49123/89523), 48.42% (55752/115143), 47.69% (79989/167740), 49.63(202085/407208) and 38.39% (301770/786028) in 2003, 2005, 2008, 2010 and 2012 respectively. 5 6 The proportion of administration of a single antimicrobial increased significantly (59.52% in 2001, 67.96% in 2010, 75.33% in 2012), 5 on the contrary, the proportion of antimicrobial used for combination therapy decreased. AUP of surgical patients declined form 76.78% (66309/86360) in 2010 to 59.14% (66309/86360, latest data) in 2012. In brief, though there are many problems, regarding antibiotics use and drug resistance, remaining to be solved, the rational use of antibiotics has improved notably after above measures were adopted in China in recent years, especially after 2010.
Pengcheng Zhou, Chunhui Li, Anhua Wu*
Infection Control Center, Xiangya Hospital, Central South University, Changsha, 410008, China.
*Corresponding author, E-mail address: xywuanhua@csu.edu.cn (Anhua Wu)
There is no conflict of interest with the article.
References:
1. Li C, Ren N, Wen X, Zhou P, Huang X, et al. Changes in Antimicrobial Use Prevalence in China:Results from Five Point Prevalence Studies. PLoS One 2013;12(8):e82785.
2. Xiao Y, Li L. Legislation of clinical antibiotic use in China. Lancet Infect Dis 2013;13(3):189-91.
3. Ministry Of Health, China. Principles for clinical use of antibiotics, 2004. http://www.moh.gov.cn/mohyzs/s3573/200804/18544.shtml
4. Ministry Of Health, China. National special rectification scheme for clinical use of antimicrobial in 2011, 2011. http://www.gdwst.gov.cn/a/zcdt/201105278814.html
5. Li C, Wu A, Wen X, Ren N. National health care-associated infection surveillance system point-prevalence trend of antibacterial use in Chinese hospitals 2001-2012. Chin J Nosocomiol 2012;22(21):4859-4861.
6. Wu A, Wen X, Li C, Ren N, Gong R, Huang X, et al. China national point prevalance survey on healthcare-associated infection and antimicrobial use in 2012. Chin J Infect control 2014(01):8-15.
Competing interests: No competing interests