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Antibiotics
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Appropriateness of Antibiotics in China - 2nd Volume
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Appropriateness of Antibiotics in China - 2nd Volume

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (1 January 2023) | Viewed by 12870

Special Issue Editors

Prof. Dr. Siyan Zhan

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Guest Editor
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Interests: pharmacoepidemiology; clinical epidemiology and evidence-based medicine
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Suodi Zhai

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Guest Editor
Department of Pharmacy Administration and Clinical Pharmacy, Peking University, Beijing, China
Interests: evidence-based pharmacy; therapeutic drug monitoring; clinical pharmacy
Special Issues, Collections and Topics in MDPI journals
Dr. Pengxiang Zhou

E-Mail Website
Guest Editor
Department of Pharmacy, Peking University Third Hospital; Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China
Interests: evidence-based pharmacy; clinical practice guidelines evaluation and development; clinical pharmacy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

From the ancient quinine to the newly synthesized oxazolidinones, antibiotics have drastically changed human civilization and modern medicine in just over 100 years. In medical institutions, antibiotics could be widely prescribed across all departments, patients, and treatment places. In the community pharmacy, antibiotics are one of the most commonly prescribed drugs. The appropriateness of antibiotics is a global issue and is mainly associated with factors, such as antibacterial resistance evaluation, the rational choice of drugs, the optimization of drug usage and dosage, and the management of drug adverse reaction and costs.

In China, antibiotic use has been strictly managed in hospitals, considering how widely it is used, the expenditure, and the serious consequences of antimicrobial abuse. Additionally, the bacterial resistance surveillance system is relatively well established in China, providing antibacterial resistance data for guidance on the appropriateness of antibiotics. Nevertheless, with the increasing complexity of clinical infection, the rational use of antibiotics in China still needs further research and improvement.

This Special Issue will focus on the appropriateness of antibiotics in China and invite scholars to report the latest research and review results. This Special Issue also seeks manuscript submissions that further improve our understanding and experience of rational antibiotic use in China.

After the successful first volume, we are delighted to launch a second volume, in which we hope to bring together the new advances in this exciting topic.

Prof. Dr. Siyan Zhan
Prof. Dr. Suodi Zhai
Dr. Pengxiang Zhou
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • appropriateness of antibiotics
  • China
  • bacterial resistance
  • optimization of antibiotics usage and dosage
  • prescription
  • medical institution
  • community pharmacy

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Published Papers (4 papers)

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Research

12 pages, 1779 KiB  
Article
Trends of Fixed-Dose Combination Antibiotic Consumption in Hospitals in China: Analysis of Data from the Center for Antibacterial Surveillance, 2013–2019
by Haishaerjiang Wushouer, Lin Hu, Yue Zhou, Yaoyao Yang, Kexin Du, Yanping Deng, Qing Yan, Xiaoqiang Yang, Zhidong Chen, Bo Zheng, Xiaodong Guan and Luwen Shi
Antibiotics 2022, 11(7), 957; https://doi.org/10.3390/antibiotics11070957 - 15 Jul 2022
Cited by 3 | Viewed by 2618
Abstract
Background: Fixed-dose combination (FDC) antibiotics can be clinically inappropriate and are concerning with regards to antimicrobial resistance, with little usage data available in low- and middle-income countries. Methods: Based on retrospective data from the Center for Antibacterial Surveillance, we investigated the consumption of [...] Read more.
Background: Fixed-dose combination (FDC) antibiotics can be clinically inappropriate and are concerning with regards to antimicrobial resistance, with little usage data available in low- and middle-income countries. Methods: Based on retrospective data from the Center for Antibacterial Surveillance, we investigated the consumption of FDC antibiotics in hospital inpatient settings in China from 1 January 2013 to 31 December 2019. The metric for assessing antibiotic consumption was the number of daily defined doses per 100 bed days (DDD/100BDs). FDC antibiotics were classified according to their composition and the Access, Watch, Reserve (AWaRe) classification of the World Health Organization. Results: A total of 24 FDC antibiotics were identified, the consumption of which increased sharply from 8.5 DDD/100BDs in 2013 to 10.2 DDD/100BDs in 2019 (p < 0.05) despite the reduction in the total antibiotic consumption in these hospitals. The increase was mainly driven by FDC antibiotics in the Not Recommended group of the AWaRe classification, whose consumption accounted for 63.0% (6.4 DDD/100BDs) of the overall FDC antibiotic consumption in 2019, while the consumption of FDC antibiotics in the Access group only accounted for 13.5% (1.4 DDD/100BDs). Conclusion: FDC antibiotic consumption significantly increased during the study period and accounted for a substantial proportion of all systemic antibiotic usage in hospitals in China. FDC antibiotics in the Not Recommended group were most frequently consumed, which raises concerns about the appropriateness of FDC antibiotic use. Full article
(This article belongs to the Special Issue Appropriateness of Antibiotics in China - 2nd Volume)
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12 pages, 1035 KiB  
Article
Pharmacokinetics and Pharmacodynamics of Colistin Methanesulfonate in Healthy Chinese Subjects after Multi-Dose Regimen
by Yaxin Fan, Yi Li, Yuancheng Chen, Jicheng Yu, Xiaofen Liu, Wanzhen Li, Beining Guo, Xin Li, Jingjing Wang, Hailan Wu, Yu Wang, Jiali Hu, Yan Guo, Fupin Hu, Xiaoyong Xu, Guoying Cao, Jufang Wu, Yingyuan Zhang, Jing Zhang and Xiaojie Wu
Antibiotics 2022, 11(6), 798; https://doi.org/10.3390/antibiotics11060798 - 14 Jun 2022
Cited by 5 | Viewed by 2870
Abstract
Colistin methanesulfonate (CMS) is an important treatment option for infections caused by carbapenem-resistant Gram-negative organisms (CROs). This study evaluated the pharmacokinetic/pharmacodynamic (PK/PD) profiles and safety of CMS in Chinese subjects following a recommended dosage. A total of 12 healthy Chinese subjects received CMS [...] Read more.
Colistin methanesulfonate (CMS) is an important treatment option for infections caused by carbapenem-resistant Gram-negative organisms (CROs). This study evaluated the pharmacokinetic/pharmacodynamic (PK/PD) profiles and safety of CMS in Chinese subjects following a recommended dosage. A total of 12 healthy Chinese subjects received CMS injections at 2.5 mg/kg once every 12 h for 7 consecutive days. The PK/PD profiles of the active form of CMS, colistin, against CROs were analyzed with the Monte Carlo simulation method. No serious adverse events were observed. The average steady-state plasma concentrations of CMS and colistin were 4.41 ± 0.75 μg/mL and 1.27 ± 0.27 μg/mL, and the steady-state exposures (AUC0–12,ss) were 52.93 ± 9.05 h·μg/mL and 15.28 ± 3.29 h·μg/mL, respectively. Colistin, at its minimum inhibitory concentration (MIC) of 0.5 μg/mL, has >90% probability to reduce CROs by ≥1 log. The PK/PD breakpoints for the ≥1 log kill were ≥MIC90 for carbapenem-resistant Klebsiella pneumoniae and Pseudomonas aeruginosa, but were ≤MIC50 for carbapenem-resistant Acinetobacter baumannii. The recommended dose regimen of CMS for 7 consecutive days was safe in Chinese subjects. The systemic exposure of colistin showed a high probability of being sufficient for most CROs, but was not sufficient for some carbapenem-resistant A. baumannii. Full article
(This article belongs to the Special Issue Appropriateness of Antibiotics in China - 2nd Volume)
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14 pages, 1654 KiB  
Article
C/MIC > 4: A Potential Instrument to Predict the Efficacy of Meropenem
by Yichang Zhao, Chenlin Xiao, Jingjing Hou, Jiamin Wu, Yiwen Xiao, Bikui Zhang, Indy Sandaradura, Hong Luo, Jinhua Li and Miao Yan
Antibiotics 2022, 11(5), 670; https://doi.org/10.3390/antibiotics11050670 - 16 May 2022
Cited by 2 | Viewed by 1941
Abstract
This prospective study aimed to explore the determinants of meropenem trough concentration (Ctrough) in patients with bacterial pneumonia and to investigate the association between its concentration and efficacy. From January 2019 to December 2019, patients with pulmonary infections were prospectively enrolled [...] Read more.
This prospective study aimed to explore the determinants of meropenem trough concentration (Ctrough) in patients with bacterial pneumonia and to investigate the association between its concentration and efficacy. From January 2019 to December 2019, patients with pulmonary infections were prospectively enrolled from the intensive care unit. Factors affecting the meropenem trough concentration were analyzed, and a multiple linear regression model was constructed. Logistic regression analyses were used to investigate the relationship between Ctrough and clinical efficacy. A total of 64 patients were enrolled, in whom 210 meropenem concentrations were measured. Of the total, 60.9% (39/64) were considered clinically successful after treatment. Ctrough may increase with increased blood urea nitrogen, albumin, and concomitant antifungal use. By contrast, concentration may decrease with increased endogenous creatinine clearance rate. Six variables, including Ctrough/minimum inhibitory concentration (MIC) > 4, were associated with the efficacy of meropenem. There was an independent correlation between Ctrough/MIC > 4 and efficacy after fully adjusting for confounding factors. Based upon renal function indexes, it is possible to predict changes in meropenem concentration and adjust the dosage precisely and individually. Ctrough/MIC > 4 is a potential instrument to predict successful treatment with meropenem. Full article
(This article belongs to the Special Issue Appropriateness of Antibiotics in China - 2nd Volume)
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9 pages, 3448 KiB  
Article
Extended Infusion of Meropenem in Neonatal Sepsis: A Historical Cohort Study
by Guangna Cao, Pengxiang Zhou, Hua Zhang, Bangkai Sun, Xiaomei Tong and Yan Xing
Antibiotics 2022, 11(3), 341; https://doi.org/10.3390/antibiotics11030341 - 4 Mar 2022
Cited by 10 | Viewed by 4518
Abstract
This single-center historical cohort study investigated the effectiveness and safety of extended infusion (EI) compared with short-term infusion (STI) of meropenem in neonatal sepsis. Patient electronic health records from Peking University Third Hospital (1 December 2011–1 April 2021) were screened. Neonates diagnosed with [...] Read more.
This single-center historical cohort study investigated the effectiveness and safety of extended infusion (EI) compared with short-term infusion (STI) of meropenem in neonatal sepsis. Patient electronic health records from Peking University Third Hospital (1 December 2011–1 April 2021) were screened. Neonates diagnosed with sepsis and treated with meropenem in the neonatal intensive care unit were included (256 patients) as STI (0.5 h, 129 patients) and EI (2–3 h, 127 patients) groups. Three-day clinical effectiveness and three-day microbial clearance were considered the main outcomes. Univariate and multivariate analyses were performed. Baseline characteristics were similar in both groups. EI of meropenem was associated with a significantly higher 3-day clinical effectiveness rate (0.335 (0.180, 0.623), p = 0.001) and 3-day microbial clearance (4.127 (1.235, 13.784), p = 0.021) than STI, with comparable safety. Subgroup analyses showed that neonates with very low birth weight benefited from EI in terms of 3-day clinical effectiveness rate (75.6% versus 56.6%, p = 0.007), with no significant difference in the 3-day clinical effectiveness (85.1% versus 78.3%, p = 0.325) and microbial clearance (6% versus 5%, p > 0.999) rates between 3 h and 2 h infusions. Thus, EI of meropenem may be associated with better effectiveness and comparable safety in treating neonatal sepsis than STI. Nonetheless, historically analyzed safety evaluation might be biased, and these findings need confirmation in randomized controlled trials of larger sample sizes. Full article
(This article belongs to the Special Issue Appropriateness of Antibiotics in China - 2nd Volume)
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