LAUSR

BACKGROUND The assessment of antibiotic use for acute upper respiratory infections (AURIs) is important for promoting the appropriateness of antibiotic prescriptions. Evaluation of antibiotic prescriptions for AURIs at a national level is very limited in China. OBJECTIVE To investigate outpatient antibiotic prescriptions for AURIs in Chinese hospitals. METHOD We used data from over 10 million outpatient and emergency department visits for AURIs, which contained information on drug prescription and diagnosis, from 94 cities and 28 provincial-regions of Mainland China. Antibiotic prescription rates for various subgroups and potential predictors of antibiotic use were estimated. Patterns of antibiotic prescriptions and proportions of individual antibiotics prescribed for different AURI types were analysed and reported. RESULTS We included 10 770 219 outpatient visits for AURIs, of which 40.8% (95% Confidence Interval (CI), 40.7%-40.8%) resulted in antibiotic prescriptions. Patient characteristics, including age, gender, payment type, AURI type, and department and season of visit were significantly associated with antibiotic prescriptions for AURIs. In total, 4 984 744 antibiotic agents were prescribed, of which 87.9% belonged to the broad-spectrum and only 36.8% were in line with the guideline recommendations. Azithromycin (13.2%), cefdinir (11.7%), cefixime (8.3%), and cefaclor (8.2%) were the most commonly prescribed antibiotics for AURIs in China. CONCLUSIONS Antibiotic prescriptions for patients with AURI in outpatient settings were prevalent nationwide in China. Antibiotic stewardship efforts targeting specific populations in outpatient settings are needed to reduce antibiotic use and promote appropriate antibiotic selection for AURIs in China.