An international team led by Zhong Nanshan, an academician of the Chinese Academy of Engineering, published a research paper in the journal Nature Medicine, presenting a new model for antimicrobial stewardship in primary healthcare facilities.
The research demonstrates that a comprehensive intervention program can successfully reduce antibiotic prescription rates for acute respiratory infections (ARI) from 83 percent to 26 percent without increasing patient safety risks.
The seven-year study was jointly conducted by researchers from the First Affiliated Hospital of Guangzhou Medical University, the University of Toronto, and Yuebei People's Hospital, among other institutions. The trial was carried out in 34 township hospitals in Nanxiong and Lechang cities in the northern part of Guangdong province.
Zhong Nanshan provides an introduction to the project. Photo: Chen Jinxia
According to Zhuo Chao, director of the Infectious Diseases Department at the First Affiliated Hospital of Guangzhou Medical University and a member of the research team, the program adopted a multi-pronged approach.
The team provided systematic training for physicians, integrated real-time diagnostic prompts into electronic medical record systems, and used statistical programs to generate monthly antibiotic prescription data for peer review. They also used smartphone apps and posters to educate patients on appropriate antimicrobial use.
Staff at primary healthcare institutions are receiving guidance on the clinical use of antibiotics. Photo: First Affiliated Hospital of Guangzhou Medical University
To validate effectiveness, the team conducted a 12-month cluster randomized controlled trial. Seventeen hospitals implemented the comprehensive program while the remaining seventeen served as the control group.
The study collected 97,239 eligible medical records of ARI through the hospitals' electronic information system, focusing on analyzing changes in antibiotic prescription rates.
The results showed that antibiotic prescription rates in the intervention group dropped to 26 percent and remained in a low range of 12 percent to 52 percent monthly. In contrast, prescription rates in the control group remained as high as 71 percent.
One year after the intervention, the team followed up with discharged patients to monitor readmission rates, confirming that reducing antibiotic use did not lead to relapse or deterioration of patient conditions. "The program did not increase the risk of hospitalization within 30 days or raise medical costs," Zhuo said.
With antimicrobial resistance posing a major global health challenge, this research provides scientific evidence from China to support rational antimicrobial use worldwide and help curb resistance.
Reporter | Chen Jinxia
