Analysis of concentration and similarity of antimicrobial agent use in China

YU Jun-xuan; YANG Yao-yao; ZHANG Wan-meng; DU Ke-xin; HU Lin; Weihsin Ko; HUANG Xian-qin; ZHENG Bo; GUAN Xiao-dong; Haishaerjiang·Wushouer; SHI Lu-wen

doi:10.3969/j.issn.1003-3734.2024.14.013

Abstract：Objective:To explore the concentration and similarity of antimicrobial agent use across various dimensions in China and offer recommendations for the optimization of antimicrobial agent management.Methods:Linear regression analysis was employed to assess the trend in the concentration of antimicrobial agent use in China.Additionally,one-way analysis of variance was utilized to examine the differences in the Herfindahl-Hirschman index(HHI)of antimicrobial agent use across different regions,provinces,and hospital levels,as well as the Jaccard index of antimicrobial agent varieties across different regions and hospital levels.Results:There was a significant increase in the overall HHI of antimicrobial agent use from 2015 to 2021,rising from 319.8 to 377.7(P<0.05).The median Jaccard index of antimicrobial agent varieties among different regions was 0.821 for tertiary hospitals and 0.716 for secondary hospitals.Furthermore,the average number of combinations of antimicrobial agents accounting for 90%of the total use in each region was 61 for tertiary hospitals and 52 for secondary hospitals.The study also found that the varieties used in the eastern,central,western,and northeastern regions accounted for a high rate of use.Conclusion:The use of antimicrobial agents in China demonstrates a trend of increasing concentration,with a notable degree of similarity in the varieties used across different geographical areas.This trend raises concerns about the potential for bacterial resistance.The study underscores the need for cautious and judicious use of antimicrobial agents and suggests that there is room for improvement in the management of antimicrobial agent varieties in China to mitigate the risk of resistance development.