{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:14:20Z","timestamp":1789776860615,"version":"4.0.1"},"reference-count":40,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"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":["81973294"],"award-info":[{"award-number":["81973294"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>(1) Background: Few studies have focused on antibiotic use and appropriateness in children in primary health institutions (PHIs). This study aimed to identify the patterns and appropriateness of antibiotic use for children in PHIs in Beijing, China. (2) Methods: Outpatient prescriptions of 327 PHIs from 2017 to 2019 for patients &lt;18 years old were collected. Prescriptions were described using quantity indicators. Antibiotics were categorized according to ATC classification J01 and Access, Watch, Reserve grouping. Appropriateness was reviewed by experts using three subtypes of irrational prescriptions (irregular, inappropriate, and abnormal). (3) Results: 20,618 prescriptions were collected in total. The antibiotic prescription rate (APR) was 15.1% (N = 3113). Among antibiotic prescriptions, J01FA Macrolides were the most used (N = 1068, 34.9%). The Watch group constituted 89.0% (N = 2818) of total antibiotic use. Bronchitis (N = 1059, 35.2%) was the most common diagnosis. A total of 292 instances of irrational antibiotic use were identified, with inappropriate prescriptions being the most prevalent subtype (N = 233, 79.8%). (4) Conclusion: Although APR for children in PHIs in Beijing was relatively low, the pattern of antibiotic use differed from other countries. Further studies are needed to optimize antibiotic use for children in PHIs under different levels of economic development.<\/jats:p>","DOI":"10.3390\/antibiotics10101248","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T22:42:18Z","timestamp":1634251338000},"page":"1248","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Outpatient Antibiotic Prescribing Patterns and Appropriateness for Children in Primary Healthcare Settings in Beijing City, China, 2017\u20132019"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1466-9840","authenticated-orcid":false,"given":"Haishaerjiang","family":"Wushouer","sequence":"first","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China"},{"name":"International Research Center for Medicinal Administration (IRCMA), Peking University, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kexin","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shicai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Luhe Teaching Hospital of Capital Medical University, Beijing 101100, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Zheng","sequence":"additional","affiliation":[{"name":"Institute of Clinical Pharmacology, Peking University First Hospital, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1290-3827","authenticated-orcid":false,"given":"Xiaodong","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China"},{"name":"International Research Center for Medicinal Administration (IRCMA), Peking University, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luwen","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China"},{"name":"International Research Center for Medicinal Administration (IRCMA), Peking University, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s13756-020-00709-6","article-title":"Secular trend analysis of antibiotic utilisation in China\u2019s hospitals 2011\u20132018, a retrospective analysis of procurement data","volume":"9","author":"Wushouer","year":"2020","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s10096-012-1795-3","article-title":"Antimicrobial agent exposure and the emergence and spread of resistant microorganisms: Issues associated with study design","volume":"32","author":"Angebault","year":"2013","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/S1473-3099(20)30596-X","article-title":"Appropriateness of antibiotic prescriptions in ambulatory care in China: A nationwide descriptive database study","volume":"21","author":"Zhao","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/S0140-6736(16)31079-0","article-title":"UN High-Level Meeting on antimicrobials\u2014What do we need?","volume":"388","author":"Laxminarayan","year":"2016","journal-title":"Lancet"},{"key":"ref_5","unstructured":"China Antimicrobial Resistance Surveillance System (2021). Epidemiological change in carbapenem-resistant Klebsiella pneumoniae: Surveillance report from China Antimicrobial Resistance Surveillance in 2014\u20132019. Chin. J. Infect. Control, 20, 175\u2013179."},{"key":"ref_6","unstructured":"(2019, September 21). National Guiding Principles for Antimicrobial, Available online: http:\/\/www.gov.cn\/xinwen\/2015-08\/27\/content_2920799.htm."},{"key":"ref_7","unstructured":"Ministry of Health of China (2019, September 21). National Guiding Principles for Antimicrobial, Available online: http:\/\/www.sda.gov.cn\/WS01\/CL0055\/10126.html."},{"key":"ref_8","unstructured":"Ministry of Health of China (2019, September 21). Notification on Establishing Surveillance Network for Antibiotic Use and Antimicrobial Resistance, Available online: http:\/\/www.nhfpc.gov.cn\/zwgkzt\/wsbysj\/200804\/18487.shtml."},{"key":"ref_9","unstructured":"Ministry of Health of China (2019, September 21). Notification on Releasing Clinical Guidance of National Essential Medicine and National Essential Medicine Formulary, Available online: http:\/\/www.nhfpc.gov.cn\/zwgkzt\/wsbysj\/201005\/47420.shtml."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S135","DOI":"10.1093\/cid\/ciy641","article-title":"Antimicrobial Stewardship in China: Systems, Actions and Future Strategies","volume":"67","author":"Xiao","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_11","unstructured":"National Health Commission of People\u2019s Republic of China (2019, June 15). Regulation Standard for Hospital Prescription Review, Available online: http:\/\/www.nhc.gov.cn\/wjw\/ywfw\/201306\/094ebc83dddc47b5a4a63ebde7224615.shtml."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"400","DOI":"10.3390\/antibiotics2030400","article-title":"Antimicrobial Stewardship: The Need to Cover All Bases","volume":"2","author":"Friedman","year":"2013","journal-title":"Antibiotics"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1086\/664771","article-title":"Evaluation of postprescription review and feedback as a method of promoting rational antimicrobial use: A multicenter intervention","volume":"33","author":"Cosgrove","year":"2012","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"ofaa298","DOI":"10.1093\/ofid\/ofaa298","article-title":"Barriers to Adherence to Antimicrobial Stewardship Postprescription Review and Feedback For Broad-Spectrum Antimicrobial Agents: A Nested Case-Control Study","volume":"7","author":"Takamatsu","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_15","first-page":"537","article-title":"What Is the More Effective Antibiotic Stewardship Intervention: Preprescription Authorization or Postprescription Review With Feedback?","volume":"64","author":"Tamma","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e759.e9","DOI":"10.1016\/j.cmi.2018.09.005","article-title":"A survey on antimicrobial stewardship in 116 tertiary hospitals in China","volume":"25","author":"Zhou","year":"2019","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/PCC.0000000000000615","article-title":"Reduction of Broad-Spectrum Antimicrobial Use in a Tertiary Children\u2019s Hospital Post Antimicrobial Stewardship Program Guideline Implementation","volume":"17","author":"Lee","year":"2016","journal-title":"Pediatric Crit. Care Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.jpeds.2020.06.008","article-title":"Benefits of a Pediatric Antimicrobial Stewardship Program in Antimicrobial Use and Quality of Prescriptions in a Referral Children\u2019s Hospital","volume":"225","author":"Jordan","year":"2020","journal-title":"J. Pediatrics"},{"key":"ref_19","first-page":"2344","article-title":"Community antibiotic prescribing for children in France from 2015 to 2017: A cross-sectional national study","volume":"75","author":"Trinh","year":"2020","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Howarth, T., Brunette, R., Davies, T., Andrews, R.M., Patel, B.K., Tong, S., Barzi, F., and Kearns, T.M. (2020). Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0233533"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e100","DOI":"10.1097\/INF.0000000000003019","article-title":"PERFORM Consortium. Respiratory Tract Infection Management and Antibiotic Prescription in Children: A Unique Study Comparing Three Levels of Healthcare in the Netherlands","volume":"40","author":"Gerrits","year":"2021","journal-title":"Pediatric Infect. Dis. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13756-016-0113-8","article-title":"Cross-border comparison of antibiotic prescriptions among children and adolescents between the north of the Netherlands and the north-west of Germany","volume":"5","author":"Dik","year":"2016","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1097\/INF.0000000000001324","article-title":"Using Prescription Patterns in Primary Care to Derive New Quality Indicators for Childhood Community Antibiotic Prescribing","volume":"35","author":"Kaguelidou","year":"2016","journal-title":"Pediatric Infect. Dis. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1111\/apa.14381","article-title":"regional working group \u201cProgetto ProBA-Progetto Bambini e Antibiotici-2014\u201d. Observational pre-post study showed that a quality improvement project reduced paediatric antibiotic prescribing rates in primary care","volume":"107","author":"Gagliotti","year":"2018","journal-title":"Acta Paediatr."},{"key":"ref_25","unstructured":"International Monetary Fund (2021, September 08). World Economic Outlook Database. Available online: https:\/\/www.imf.org\/en\/Publications\/WEO\/weo-database\/2021\/April\/download-entire-database."},{"key":"ref_26","first-page":"486","article-title":"Antibiotic formulary restriction: Theory & practice","volume":"34","author":"Xiao","year":"2012","journal-title":"Beijing Med. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"39361","DOI":"10.1038\/srep39361","article-title":"Public reporting as a prescriptions quality improvement measure in primary care settings in China: Variations in effects associated with diagnoses","volume":"6","author":"Tang","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e1258","DOI":"10.1016\/S2214-109X(17)30383-2","article-title":"Effect of a training and educational intervention for physicians and caregivers on antibiotic prescribing for upper respiratory tract infections in children at primary care facilities in rural China: A cluster-randomised controlled trial","volume":"5","author":"Wei","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1001\/jamainternmed.2014.5214","article-title":"Use and Prescription of Antibiotics in Primary Health Care Settings in China","volume":"174","author":"Wang","year":"2014","journal-title":"JAMA Intern. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"617260","DOI":"10.3389\/fphar.2020.617260","article-title":"Evaluation of the Quality of Antibiotic Prescribing in Primary Care: A Multicenter Longitudinal Study From Shenzhen, China","volume":"11","author":"Gong","year":"2021","journal-title":"Front. Pharmacol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1287334","DOI":"10.1080\/16549716.2017.1287334","article-title":"Antibiotic prescribing for upper respiratory infections among children in rural China: A cross-sectional study of outpatient prescriptions","volume":"10","author":"Zhang","year":"2017","journal-title":"Glob. Health Action"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e000854","DOI":"10.1136\/bmjgh-2018-000854","article-title":"Why patients prefer high-level healthcare facilities: A qualitative study using focus groups in rural and urban China","volume":"3","author":"Liu","year":"2018","journal-title":"BMJ Glob. Health"},{"key":"ref_33","unstructured":"European Centre for Disease Prevention and Control (2020). Antimicrobial Consumption in the EU\/EEA\u2014Annual Epidemiological Report 2019, ECDC."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e20174124","DOI":"10.1542\/peds.2017-4124","article-title":"Out  patient Antibiotic Use and the Need for Increased Antibiotic Stewardship Efforts","volume":"141","author":"Zetts","year":"2018","journal-title":"Pediatrics"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Joint Task Force on Practice Parameters (2010). Drug allergy: An updated practice parameter. Ann. Allergy Asthma Immunol., 105, 259\u2013273.","DOI":"10.1016\/j.anai.2010.08.002"},{"key":"ref_36","first-page":"412","article-title":"Penicillin allergy and diagnostic methods","volume":"10","author":"Meng","year":"2016","journal-title":"Chin. J. Allergy Clin. Immunol."},{"key":"ref_37","unstructured":"World Health Organization (2019, September 21). WHO Model List of Essential Medicines (20th List). Available online: https:\/\/www.who.int\/medicines\/publications\/essentialmedicines\/20th_EML2017.pdf?%20ua=."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1093\/jpids\/piz085","article-title":"Treatment of Carbapenem-Resistant Enterobacteriaceae Infections in Children","volume":"9","author":"Chiotos","year":"2020","journal-title":"J. Pediatric Infect. Dis. Soc."},{"key":"ref_39","unstructured":"World Collaborating Centre for Drug Statistics Methodology (2019, June 15). Guidelines for ATC classification and DDD Assignment 2019. Available online: https:\/\/www.whocc.no\/filearchive\/publications\/2019_guidelines_web.pdf."},{"key":"ref_40","unstructured":"WHO (2021, September 08). 2019 AWaRe Classification Antibiotics [EB\/OL]. Available online: https:\/\/www.who.int\/medicines\/news\/2019\/WHO_releases2019AWaRe_classification_antibiotics\/en\/."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/10\/10\/1248\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:14:58Z","timestamp":1760166898000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/10\/10\/1248"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,14]]},"references-count":40,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["antibiotics10101248"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics10101248","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,14]]}}}