Campaign aims to overhaul antibiotics use

A campaign that started last year to overhaul the clinical use of antibiotics around the country is encouraging hospitals to improve their performance.

One of the objectives of the campaign is to slow down the development of multi-drug-resistant bacteria.

Hu Bijie, an expert on infectious diseases from the Shanghai-based Zhongshan Hospital of Fudan University, said on Thursday that higher standards have been set for hospitals after an inspection on the use of antibiotics carried out by the Ministry of Health on Oct 17.

"According to the standards set in 2011, hospitals had to test at least 30 percent of the inpatients under antibiotic treatment to decide on the kind of antibiotic treatment they should get," Hu said. "However, the ministry found out that most of the hospitals inspected last year achieved this goal, which meant that the standards could be raised."

This year, the ministry ordered that at least 50 percent of the inpatients treated with limited-use antibiotics should be tested, and that at least 80 percent of inpatients treated with limited-use antibiotics should be tested.

According to Hu, who was a member of the team that drafted the 2012 standards, the changes are a result of the ministry's attempt to implement stricter requirements.

"It's very hard for hospitals to achieve that goal, but we should continue the campaign," said Hu.

In 2004, the Ministry of Health issued guidelines on the clinical use of antibiotics. The ministry created three categories: non-limited use, limited use and special use, based on their prices and side effects.

The guidelines required hospitals to sort the antibiotics they used and assign different prescription rights to doctors on different levels.

In November 2011, the ministry conducted an inspection on antibiotic use in about 300 hospitals in 30 provincial-level areas, and in May this year, it changed the guidelines into a regulation that all medical institutions have to follow.

It started a second inspection on Oct 17, covering about 200 hospitals across the Chinese mainland, excluding the Tibet autonomous region.

However, the inspections have focused on grade-two and grade-three hospitals, and may failed to properly grassroots hospitals, said Hu.

"Antibiotics abuse is also a serious problem in grassroots hospitals. We used to think that drug-resistant bacteria was a problem only in large hospitals, which have access to advanced antibiotics. However, grade-one hospitals and healthcare centers are also able to obtain those drugs nowadays," Hu said.

"Hopefully, when large hospitals are able to successfully control the use of antibiotics, they will set an example for grassroots institutions. Local health authorities can also boost their management of these hospitals," he added.