PMID- 30418035
OWN - NLM
STAT- MEDLINE
DCOM- 20190726
LR  - 20190726
IS  - 1744-8379 (Electronic)
IS  - 1473-7167 (Linking)
VI  - 19
IP  - 4
DP  - 2019 Aug
TI  - Mixed effects of restriction strategies in antimicrobial stewardship programs on 
      antimicrobial use in 121 tertiary hospitals in China, 2013-2017.
PG  - 483-489
LID - 10.1080/14737167.2018.1547635 [doi]
AB  - Background: The research evaluated the impact of intravenous antimicrobial 
      restriction strategy (IARS) on different types of hospitals in China for 
      evidence-based management, for outpatients implemented in 2016. Methods: Based on 
      panel data on antimicrobial use in 121 tertiary hospitals in Zhejiang, China, 
      segmented regression analysis was used to evaluate the impact of IARS in 
      children's hospitals (CHs), obstetrics and gynecology hospitals (OGHs), women's 
      and children's hospitals (WCHs), traditional Chinese medicine hospitals (TCMHs) 
      and general hospitals (GHs). Antimicrobial use was measured using the percentage 
      of total encounters with prescribing and the percentage of total drug expenditure 
      relating to antimicrobials (APP and AEP). Results: There was a downward baseline 
      slope of APP in all types of hospitals and AEP in WCHs, TCMHs and GHs (P < 0.01). 
      After IARS, a level reduction in AEP in CHs (-3.14%, 95% CI = -6.21 to 0.06), 
      WCHs (-1.33%, 95% CI = -2.44 to 0.22) and TCMHs (-0.85%, 95%CI = -1.51 to 0.18). 
      After IARS, the slope of AEP changed significantly in OGHs (-0.42%, 95%CI = -0.81 
      to 0.03) and WCHs (0.29%, 95% CI = 0.08 to 0.49), and the slope of APP changed 
      significantly in CHs (2.35%, 95%CI = 1.20 to 3.49). Conclusions: IARS had the 
      mixed effects including positive effect in AEP and no significant change in APP, 
      and an unexpected rise in APP in CHs needs further study.
FAU - Chen, Haihong
AU  - Chen H
AD  - a School of Medicine and Health Management, Tongji Medical College , Huazhong 
      University of Science and Technology , Wuhan , Hubei Province , China.
FAU - Liu, Chenxi
AU  - Liu C
AD  - a School of Medicine and Health Management, Tongji Medical College , Huazhong 
      University of Science and Technology , Wuhan , Hubei Province , China.
FAU - Liu, Junjie
AU  - Liu J
AD  - a School of Medicine and Health Management, Tongji Medical College , Huazhong 
      University of Science and Technology , Wuhan , Hubei Province , China.
FAU - Tang, Yuqing
AU  - Tang Y
AD  - a School of Medicine and Health Management, Tongji Medical College , Huazhong 
      University of Science and Technology , Wuhan , Hubei Province , China.
FAU - Zhang, Xinping
AU  - Zhang X
AD  - a School of Medicine and Health Management, Tongji Medical College , Huazhong 
      University of Science and Technology , Wuhan , Hubei Province , China.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20181119
PL  - England
TA  - Expert Rev Pharmacoecon Outcomes Res
JT  - Expert review of pharmacoeconomics & outcomes research
JID - 101132257
RN  - 0 (Anti-Infective Agents)
MH  - Administration, Intravenous
MH  - Anti-Infective Agents/*administration & dosage/economics
MH  - Antimicrobial Stewardship/economics/*organization & administration
MH  - China
MH  - Evidence-Based Medicine
MH  - Health Expenditures/statistics & numerical data
MH  - Humans
MH  - Outpatient Clinics, Hospital/economics/statistics & numerical data
MH  - Practice Patterns, Physicians'/standards/*statistics & numerical data
MH  - Regression Analysis
MH  - Tertiary Care Centers/economics/statistics & numerical data
OTO - NOTNLM
OT  - Antimicrobial stewardship programs
OT  - antimicrobial expenditure
OT  - antimicrobial prescribing
OT  - interrupted time series
OT  - restriction strategy
EDAT- 2018/11/13 06:00
MHDA- 2019/07/28 06:00
CRDT- 2018/11/13 06:00
PHST- 2018/11/13 06:00 [pubmed]
PHST- 2019/07/28 06:00 [medline]
PHST- 2018/11/13 06:00 [entrez]
AID - 10.1080/14737167.2018.1547635 [doi]
PST - ppublish
SO  - Expert Rev Pharmacoecon Outcomes Res. 2019 Aug;19(4):483-489. doi: 
      10.1080/14737167.2018.1547635. Epub 2018 Nov 19.