Objective To provide a detailed analysis of the use of macrolides in community health service centers in Shanghai,and to provide empirical evidence for the development of relevant management systems and measures in community health service centers.Methods A retrospective survey was conducted to analyze the number of macrolides and defined daily doses(DDDs)of macrolides in outpatient and inpatient settings from the Shanghai Community Antibiotics Clinical Application Monitoring Network from 2015 to 2021.Results Among the community health service centers included in the survey,7-8 types of macrolides were stably used,with the overall DDDs decreased from the 3rd to 4th from 2015 to 2021.The proportion of macrolide DDDs in all antimicrobial DDDs showed a decreasing trend year by year,showing a decrease from 17.49％in 2015 to 10.82％in 2021 in outpatient settings,and a decrease from 12.05％in 2015 to 3.77％in 2021 in inpatient settings.The average of macrolide DDDs in the hospitalization gradually decreased from 568.70 in 2017 to 93.91 in 2021.The average of macrolide DDDs in outpatient settings gradually decreased from 31286.19 in 2015 to 10624.46 in 2021.In terms of dosage form,the proportion of oral macrolide DDDs increased from 93.88％in 2015 to 98.82％in 2021.From 2015 to 2021,azithromycin,erythromycin,roxithromycin,clarithromycin oral preparations,and azithromycin injections were the dominant macrolides in Community Health Service Centers in Shanghai.From 2015 to 2021,the DDDs of macrolide drugs,mainly erythromycin,roxithromycin,clarithromycin oral preparations,and azithromycin injections,showed a decreasing trend year by year.However,from 2015 to 2021,the DDDs of oral azithromycin preparations showed an upward trend,showing a stark contrast to the DDDs of other macrolide drugs.According to data from the Shanghai Bacterial and Fungal Drug Resistance Monitoring Network,from 2015 to 2021,methicillin-resistant Staphylococcus aureus(MRSA),Streptococcus pneumoniae,Streptococcus aeruginosa,and β-hemolytic streptococcus had an average resistance rate to erythromycin at 50％and higher,with Streptococcus pneumoniae on the top.Azithromycin was sensitive to Haemophilus influenzae,but it also showed a decreasing trend year by year.The irrational use of macrolides has been decreasing year by year from 2015 to 2021,with the most significant decreasing trend observed in improper usage/dosage and drug selection.Improper usage/dosage rate decreased from 17.00％in 2015 to 5.47％in 2021,and improper drug selection rate decreased from 11.37％in 2015 to 6.08％in 2021.From 2015 to 2021,the use of macrolide drugs did not exceed the instructions.Conclusion The frequency of macrolide use in community health service centers in Shanghai annually decreases,but concentratedly used.The drug resistance should be concerned.
community health service centermacrolidesazithromycinmedication frequency
维普
万方数据
