Determining the impact of the COVID-19 pandemic on the consumption of antibiotics in Shaanxi province, China: an interrupted time-series analysis

BackgroundThe COVID-19 pandemic, as well as associated prevention and control measures, have impacted the entire healthcare system, including the use patterns of medicine. However, the impact of COVID-19 on the use of antibiotics has not yet been extensively evaluated in China. This study aimed to e...

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Main Authors: Wenjing Ji, Yifei Zhao, Jiaxi Du, Hang Zhao, David J. McIver, Dan Ye, Kangkang Yan, Xiaolin Wei, Yu Fang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1475207/full
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author Wenjing Ji
Yifei Zhao
Jiaxi Du
Hang Zhao
David J. McIver
Dan Ye
Kangkang Yan
Xiaolin Wei
Yu Fang
author_facet Wenjing Ji
Yifei Zhao
Jiaxi Du
Hang Zhao
David J. McIver
Dan Ye
Kangkang Yan
Xiaolin Wei
Yu Fang
author_sort Wenjing Ji
collection DOAJ
description BackgroundThe COVID-19 pandemic, as well as associated prevention and control measures, have impacted the entire healthcare system, including the use patterns of medicine. However, the impact of COVID-19 on the use of antibiotics has not yet been extensively evaluated in China. This study aimed to evaluate the impact of the pandemic on the consumption and expenditure of antibiotics in public healthcare institutions in Shaanxi Province, China.MethodsWe used longitudinal data from the Shaanxi provincial drug procurement database in this study. An interrupted time-series analysis was performed to evaluate the effects of COVID-19 on consumption and expenditures of antibiotics in public healthcare institutions in Shaanxi from 1 January 2017 to 31 December 2020. Antibiotic consumption was expressed as the number of defined daily doses (DDDs) per 1,000 residents per day (DIDs), based on the population of Shaanxi Province at the end of each year from the National Bureau of Statistics. The pre-pandemic period was from January 2017 to January 2020, and the post-pandemic period was from February 2020 to December 2020.ResultsA declining trend in antibiotic consumption was observed immediately following the COVID-19 pandemic (β2 = −4.099; p < 0.001). Regarding the route of administration, a larger decrease in the consumption of oral antibiotics was observed compared to parenteral (β2 = −3.056; p < 0.001). The decrease in antibiotic consumption in the Watch category (β2 = −2.164; p < 0.001) was larger than in the Access category (β2 = −1.773; p < 0.001), and penicillins (J01C) (β2 = −1.261; p < 0.001) showed a higher decline than cephalosporins (J01D) (β2 = −1.147; p < 0.001). An increasing trend of broad-spectrum antibiotic consumption was observed after the onset of the pandemic (β3 = 0.021; p = 0.015). Expenditures on and consumption of antibiotics follow essentially the same trend.ConclusionDespite an initial decline in antibiotic consumption at the start of the COVID-19 pandemic, it had returned to prior levels by the end of 2020. Findings underscore the continued importance of antibiotic stewardship initiatives.
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spelling doaj-art-5dbfa83828ee4712bc3e2d0e57d2977e2025-08-20T03:12:53ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-02-011310.3389/fpubh.2025.14752071475207Determining the impact of the COVID-19 pandemic on the consumption of antibiotics in Shaanxi province, China: an interrupted time-series analysisWenjing Ji0Yifei Zhao1Jiaxi Du2Hang Zhao3David J. McIver4Dan Ye5Kangkang Yan6Xiaolin Wei7Yu Fang8Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, ChinaDepartment of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, ChinaDepartment of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, ChinaDepartment of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, ChinaInstitute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United StatesDepartment of Pharmacy, Xi'an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, ChinaDepartment of Pharmacy, Xi'an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, ChinaDalla Lana School of Public Health, University of Toronto, Toronto, ON, CanadaDepartment of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, ChinaBackgroundThe COVID-19 pandemic, as well as associated prevention and control measures, have impacted the entire healthcare system, including the use patterns of medicine. However, the impact of COVID-19 on the use of antibiotics has not yet been extensively evaluated in China. This study aimed to evaluate the impact of the pandemic on the consumption and expenditure of antibiotics in public healthcare institutions in Shaanxi Province, China.MethodsWe used longitudinal data from the Shaanxi provincial drug procurement database in this study. An interrupted time-series analysis was performed to evaluate the effects of COVID-19 on consumption and expenditures of antibiotics in public healthcare institutions in Shaanxi from 1 January 2017 to 31 December 2020. Antibiotic consumption was expressed as the number of defined daily doses (DDDs) per 1,000 residents per day (DIDs), based on the population of Shaanxi Province at the end of each year from the National Bureau of Statistics. The pre-pandemic period was from January 2017 to January 2020, and the post-pandemic period was from February 2020 to December 2020.ResultsA declining trend in antibiotic consumption was observed immediately following the COVID-19 pandemic (β2 = −4.099; p < 0.001). Regarding the route of administration, a larger decrease in the consumption of oral antibiotics was observed compared to parenteral (β2 = −3.056; p < 0.001). The decrease in antibiotic consumption in the Watch category (β2 = −2.164; p < 0.001) was larger than in the Access category (β2 = −1.773; p < 0.001), and penicillins (J01C) (β2 = −1.261; p < 0.001) showed a higher decline than cephalosporins (J01D) (β2 = −1.147; p < 0.001). An increasing trend of broad-spectrum antibiotic consumption was observed after the onset of the pandemic (β3 = 0.021; p = 0.015). Expenditures on and consumption of antibiotics follow essentially the same trend.ConclusionDespite an initial decline in antibiotic consumption at the start of the COVID-19 pandemic, it had returned to prior levels by the end of 2020. Findings underscore the continued importance of antibiotic stewardship initiatives.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1475207/fullantibioticsconsumptionexpenditureCOVID-19interrupted time seriesChina
spellingShingle Wenjing Ji
Yifei Zhao
Jiaxi Du
Hang Zhao
David J. McIver
Dan Ye
Kangkang Yan
Xiaolin Wei
Yu Fang
Determining the impact of the COVID-19 pandemic on the consumption of antibiotics in Shaanxi province, China: an interrupted time-series analysis
Frontiers in Public Health
antibiotics
consumption
expenditure
COVID-19
interrupted time series
China
title Determining the impact of the COVID-19 pandemic on the consumption of antibiotics in Shaanxi province, China: an interrupted time-series analysis
title_full Determining the impact of the COVID-19 pandemic on the consumption of antibiotics in Shaanxi province, China: an interrupted time-series analysis
title_fullStr Determining the impact of the COVID-19 pandemic on the consumption of antibiotics in Shaanxi province, China: an interrupted time-series analysis
title_full_unstemmed Determining the impact of the COVID-19 pandemic on the consumption of antibiotics in Shaanxi province, China: an interrupted time-series analysis
title_short Determining the impact of the COVID-19 pandemic on the consumption of antibiotics in Shaanxi province, China: an interrupted time-series analysis
title_sort determining the impact of the covid 19 pandemic on the consumption of antibiotics in shaanxi province china an interrupted time series analysis
topic antibiotics
consumption
expenditure
COVID-19
interrupted time series
China
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1475207/full
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