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Antibiotic resistance in China—a major future challenge

2009; Elsevier BV; Volume: 373; Issue: 9657 Linguagem: Inglês

10.1016/s0140-6736(08)61956-x

1474-547X

Andreas Heddini, Otto Cars, Qiang Sun, Göran Tomson,

Global Maternal and Child Health

Longde Wang and colleagues (Nov 1, p 1697)1Wang L Wang Y Jin S et al.Emergence and control of infectious diseases in China.Lancet. 2008; 372: 1598-1605Summary Full Text Full Text PDF PubMed Scopus (282) Google Scholar outline the future challenges posed by infectious diseases in the Chinese context. Infectious diseases remain a major problem in China today and Wang and colleagues provide a comprehensive review of current and emerging infectious diseases and their control. Strikingly, however, the increasing threat of antibiotic resistance is only briefly mentioned.The situation with respect to overuse of antibiotics and antibiotic resistance in China is severe.2Reynolds L McKee M Factors influencing antibiotic prescribing in China: an exploratory analysis.Health Policy. 2008; (published online Oct 13.)https://doi.org/10.1016/j.healthpol.2008.09.002Summary Full Text Full Text PDF PubMed Scopus (175) Google Scholar Several factors are involved, including a health system with strong financial incentives for drug prescribing.3Sun Q Santoro MA Meng Q Liu C Eggleston K Pharmaceutical policy in China.Health Aff. 2008; 27: 1042-1050Crossref PubMed Scopus (132) Google Scholar Around 75% of patients with seasonal influenza are estimated to be prescribed antibiotics, and the rate of antibiotic prescription to inpatients is 80%.4Zheng Y Zhou Z The root causes of the abuse of antibiotics, harm and the rational use of the strategy.Hospital Management Forum. 2007; 123 (in Chinese).: 23-27Google Scholar In a study of resistance patterns of several common bacteria in China in 1999 and 2001,5Zhang R Eggleston K Rotimi V Zeckhauser RJ Antibiotic resistance as a global threat: evidence from China, Kuwait and the United States.Global Health. 2006; 2: 6Crossref PubMed Scopus (193) Google Scholar the mean prevalence of resistance among hospital-acquired infections was as high as 41% and that among community-acquired infections was 26%. China also has the world's most rapid growth rate of resistance (22% average growth in a study spanning 1994 to 2000).5Zhang R Eggleston K Rotimi V Zeckhauser RJ Antibiotic resistance as a global threat: evidence from China, Kuwait and the United States.Global Health. 2006; 2: 6Crossref PubMed Scopus (193) Google ScholarThe faceless threat of antibiotic resistance is likely to be one of the greatest challenges to global health during the 21st century, with a direct effect on health indicators in low-income, middle-income, and high-income countries. It is positive that China's new health system reform suggests a pharmaceutical policy that includes a strategy for rational drug use. What happens in China matters for the world.We declare that we have no conflict of interest. Longde Wang and colleagues (Nov 1, p 1697)1Wang L Wang Y Jin S et al.Emergence and control of infectious diseases in China.Lancet. 2008; 372: 1598-1605Summary Full Text Full Text PDF PubMed Scopus (282) Google Scholar outline the future challenges posed by infectious diseases in the Chinese context. Infectious diseases remain a major problem in China today and Wang and colleagues provide a comprehensive review of current and emerging infectious diseases and their control. Strikingly, however, the increasing threat of antibiotic resistance is only briefly mentioned. The situation with respect to overuse of antibiotics and antibiotic resistance in China is severe.2Reynolds L McKee M Factors influencing antibiotic prescribing in China: an exploratory analysis.Health Policy. 2008; (published online Oct 13.)https://doi.org/10.1016/j.healthpol.2008.09.002Summary Full Text Full Text PDF PubMed Scopus (175) Google Scholar Several factors are involved, including a health system with strong financial incentives for drug prescribing.3Sun Q Santoro MA Meng Q Liu C Eggleston K Pharmaceutical policy in China.Health Aff. 2008; 27: 1042-1050Crossref PubMed Scopus (132) Google Scholar Around 75% of patients with seasonal influenza are estimated to be prescribed antibiotics, and the rate of antibiotic prescription to inpatients is 80%.4Zheng Y Zhou Z The root causes of the abuse of antibiotics, harm and the rational use of the strategy.Hospital Management Forum. 2007; 123 (in Chinese).: 23-27Google Scholar In a study of resistance patterns of several common bacteria in China in 1999 and 2001,5Zhang R Eggleston K Rotimi V Zeckhauser RJ Antibiotic resistance as a global threat: evidence from China, Kuwait and the United States.Global Health. 2006; 2: 6Crossref PubMed Scopus (193) Google Scholar the mean prevalence of resistance among hospital-acquired infections was as high as 41% and that among community-acquired infections was 26%. China also has the world's most rapid growth rate of resistance (22% average growth in a study spanning 1994 to 2000).5Zhang R Eggleston K Rotimi V Zeckhauser RJ Antibiotic resistance as a global threat: evidence from China, Kuwait and the United States.Global Health. 2006; 2: 6Crossref PubMed Scopus (193) Google Scholar The faceless threat of antibiotic resistance is likely to be one of the greatest challenges to global health during the 21st century, with a direct effect on health indicators in low-income, middle-income, and high-income countries. It is positive that China's new health system reform suggests a pharmaceutical policy that includes a strategy for rational drug use. What happens in China matters for the world. We declare that we have no conflict of interest. Challenges arising from China's two-child policyChina's recent two-child policy opens the door for both desired outcomes and unanticipated challenges for some families. In 2015, two teenage girls threatened their parents if they sought to have a second child—one girl threatened to commit suicide1 and the other to become pregnant.2 Full-Text PDF