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Interrupted time-series analysis to evaluate the impact of a national antimicrobial stewardship campaign on antibiotic use among primary healthcare institutions: evidence from Central China

Published online by Cambridge University Press:  10 September 2025

Yirui Xu Open the ORCID record for Yirui Xu [Opens in a new window] ,
Yingying Wang Open the ORCID record for Yingying Wang [Opens in a new window] ,
Hanyu Qian Open the ORCID record for Hanyu Qian [Opens in a new window] ,
Xian Liu Open the ORCID record for Xian Liu [Opens in a new window] ,
Dongyang Lan Open the ORCID record for Dongyang Lan [Opens in a new window] ,
Jue Wang Open the ORCID record for Jue Wang [Opens in a new window]  and
Yuxiao Zhang Open the ORCID record for Yuxiao Zhang [Opens in a new window]
Yirui Xu
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan City, Hubei Province, China
Yingying Wang
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan City, Hubei Province, China
Hanyu Qian
Affiliation:
Department of Social Medicine and Health Management, School of Public Health, Wuhan University, Wuhan City, Hubei Province, China
Xian Liu
Affiliation:
Department of Social Medicine and Health Management, School of Public Health, Wuhan University, Wuhan City, Hubei Province, China
Dongyang Lan
Affiliation:
School of Pharmaceutical Sciences, Wuhan University, Wuhan City, Hubei Province, China
Jue Wang
Affiliation:
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan City, Hubei Province, China
Yuxiao Zhang*
Affiliation:
Department of Social Medicine and Health Management, School of Public Health, Wuhan University, Wuhan City, Hubei Province, China
*
Corresponding author: Yuxiao Zhang; Email: 00031300@whu.edu.cn
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Abstract

Objective:

Antimicrobial resistance (AMR) is a global health challenge, highlighting the need for antibiotic stewardship policies. We evaluated the impact of the National Action Plan to Contain Antimicrobial Resistance (2022–2025) on antibiotic use among primary healthcare institutions (PHIs) in Central China.

Design:

A segmented interrupted time-series analysis from January 2021 to December 2023.

Methods:

We collected data from 1510 PHIs, by region, types of healthcare institutions and medication type, assessing antibiotic consumption using defined daily doses per 1000 inhabitants per day and the quality by the percentage of broad-spectrum antibiotics.

Results:

Post-intervention, antibiotic consumption declined by −35.96% (95%CI: –49.34 to –22.57), and the proportion of broad-spectrum antibiotic use decreased by –41.97% (–61.74 to –22.20). Consumption dropped significantly in both moderately developed areas and underdeveloped areas, while highly developed areas saw the largest reduction in broad-spectrum antibiotic use. Rural PHIs also showed notable declines in both overall antibiotic consumption and broad-spectrum usage.

Conclusions:

The policy was associated with a reduction in antibiotic use across PHIs, though regional disparities in its implementation suggest uneven benefits.

Information

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 46 , Issue 11 , November 2025 , pp. 1151 - 1157
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

#

These authors contributed equally to this work and should be considered as co-first authors.

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