{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T19:10:01Z","timestamp":1788981001726,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T00:00:00Z","timestamp":1635897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["71673147 72074123"],"award-info":[{"award-number":["71673147 72074123"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001547","name":"China Medical Board","doi-asserted-by":"publisher","award":["17-277"],"award-info":[{"award-number":["17-277"]}],"id":[{"id":"10.13039\/100001547","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Objectives:<\/jats:bold> This study aimed to identify the trends in antibiotics utilization and patients costs, evaluating the effect of the policy and exploring factors associated with the irrational use of antibiotics.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Based on the Cooperation Project Database of Hospital Prescriptions, data were collected from 89 tertiary hospitals in nine cities in China during 2016\u20132019. The study sample consisted of prescription records with antibiotics for 3,422,710 outpatient and emergency visits and 26, 118, 436 inpatient hospitalizations.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> For outpatients, the proportion of treated with antibiotics declined from 14.72 to 13.92% significantly (<jats:italic>p<\/jats:italic> &amp;lt; 0.01). The proportion of antibiotic costs for outpatients decreased from 5.79 to 4.45% significantly (<jats:italic>p<\/jats:italic> &amp;lt; 0.01). For emergency patients, the proportion of treated with antibiotics increased from 39.31 to 43.45% significantly (<jats:italic>p<\/jats:italic> &amp;lt; 0.01). The proportion of antibiotic costs for emergency patients decreased from 36.44 to 34.69%, with no significant change (<jats:italic>p<\/jats:italic> = 0.87). For inpatients, the proportion of treated with antibiotics increased from 23.82 to 27.25% significantly (<jats:italic>p<\/jats:italic> &amp;lt; 0.01). The proportion of antibiotic costs for outpatients decreased from 18.09 to 17.19% with no statistical significance (<jats:italic>p<\/jats:italic> = 0.89). Other \u03b2-lactam antibacterials (1,663.03 ten thousand DDD) far exceeded other antibiotics categories. Stablely ranked first, followed by Macrolides, lincosamide and streptogramins (965.74 ten thousand DDD), Quinolone antibacterials (710.42 ten thousand DDD), and \u03b2-lactam antibacterials, penicillins (497.01 ten thousand DDD).<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> The proportion of treated with antibiotics for outpatients and inpatients meet the WHO standards. The antibiotics use varied by different survey areas, clinical departments, patient gender, patient age and antibiotics categories. More efforts should focus on improving the appropriateness of antibiotics use at the individual level.<\/jats:p>","DOI":"10.3389\/fphar.2021.757309","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T04:35:33Z","timestamp":1635914133000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Trends and Patterns of Antibiotics Use in China\u2019s Urban Tertiary Hospitals, 2016\u201319"],"prefix":"10.3389","volume":"12","author":[{"given":"Yulei","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Qiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rouli","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e0118868","DOI":"10.1371\/journal.pone.0118868","article-title":"Significant Reduction of Antibiotic Consumption and Patients' Costs after an Action Plan in China, 2010-2014","volume":"10","author":"Bao","year":"2015","journal-title":"PLoS One"},{"key":"B2","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/1471-2334-14-13","article-title":"A Systematic Review and Meta-Analysis of the Effects of Antibiotic Consumption on Antibiotic Resistance","volume":"14","author":"Bell","year":"2014","journal-title":"BMC Infect. 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