单位：[1]Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China[2]Department of Pulmonary and Critical Care Medicine, China–Japan Friendship Hospital, Beijing, China[3]National ClinicalResearch Center for Respiratory Diseases, Beijing, China[4]Institute of Respiratory Medicine, Chinese Academy of MedicalScience, Beijing, China[5]Chinese Alliance for Respiratory Diseases in Primary Care, Beijing, China
Background: The evidence for real-world antibiotic use in treating acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is insufficient. This study aimed to investigate real-world antibiotic use in the management of AECOPD in China. Methods: All hospitalized AECOPD patients from the acute exacerbation of chronic obstructive pulmonary disease inpatient registry (ACURE) study conducted at 163 sites between January 2018 and December 2019 were screened according to the eligible criteria. The eligible study population was divided into secondary and tertiary hospital groups. Patients' baseline characteristics, antibiotic use, and bacterial pathogen characteristics were retrieved and analyzed using SPSS 23.0. Results: A total of 1663 patients were included in the study, including 194 patients from secondary hospitals and 1469 patients from tertiary hospitals. Among the 1663 AECOPD patients enrolled, 1434 (86.2%) received antibiotic treatment, comprising approximately 85.6% and 86.3% of patients in the secondary and tertiary hospital groups, respectively. The median antibiotic therapy duration was 9.0 (interquartile range [IQR]: 7.0 - 11.0)degrees days. Regarding the routes of antibiotic use, 1400 (97.6%) patients received intravenous antibiotics, 18 (1.3%) patients received oral antibiotics, 15 (1.0%) patients received both intravenous and oral antibiotics, and one (0.1%) patient received both oral and nebulized antibiotic treatment. In addition, cephalosporin, penicillin, and quinolone were the most commonly prescribed antibiotics (43.6%, 37.0%, and 34.2%, respectively). In total, 990 (56.5%) patients underwent pathogen examinations; the proportion of patients receiving pathogen examinations in the second hospital group was significantly lower than that in the tertiary hospital group (46.4% vs 61.3%, p < 0.001). Conclusion: This study demonstrates that an antibiotic overuse may exist in the treatment of AECOPD in China. Measures should be taken to prevent the overuse of antibiotics and potential antimicrobial resistance (AMR) in Chinese AECOPD patients.
基金：
National Key R&D Program of China [2018YFC1315100, 2016YFC1303900, 2016YFC1304700]; CAMS Innovation Fund for Medical Sciences [2018-I2M-1-001]; Respiratory Disease Clinical Research Public Welfare Program of China Song Qingling Foundation [2018MZFC-032]
第一作者单位：[1]Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
通讯作者：
通讯机构：[2]Department of Pulmonary and Critical Care Medicine, China–Japan Friendship Hospital, Beijing, China[3]National ClinicalResearch Center for Respiratory Diseases, Beijing, China[4]Institute of Respiratory Medicine, Chinese Academy of MedicalScience, Beijing, China
推荐引用方式(GB/T 7714)：
Ma Yiming,Huang Ke,Liang Chen,et al.Real-world antibiotic use in treating acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in China: Evidence from the ACURE study[J].FRONTIERS in PHARMACOLOGY.2021,12:doi:10.3389/fphar.2021.649884.
APA：
Ma, Yiming,Huang, Ke,Liang, Chen,Mao, Xihua,Zhang, Yaowen...&Chen, Yan.(2021).Real-world antibiotic use in treating acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in China: Evidence from the ACURE study.FRONTIERS in PHARMACOLOGY,12,
MLA：
Ma, Yiming,et al."Real-world antibiotic use in treating acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in China: Evidence from the ACURE study".FRONTIERS in PHARMACOLOGY 12.(2021)
