China's Welcome Progress Against Antibiotic-Resistant Bacteria

A crackdown on overprescription at Chinese hospitals is helping prevent "superbugs," but hospital dependence on drug profits remain an obstacle.
Doctor Zhang Shutian (R) looks at a medical photograph of a patient's stomach in the Gastroenterology and Hepatolgy ward at the Beijing Friendship Hospital. (David Gray/Reuters)

The rise of “superbugs,” lethal bacteria that can’t be killed by most antibiotics, owes particular thanks to China, where antibiotics are handed out like throat lozenges because hospitals depend on overprescribing them to make money. That’s part of why some scientists think deaths from infection could soon hit levels not seen since the early 20th century.

What saves the world from that fate could be this: In 2011, China’s Ministry of Health started cracking down on antibiotics overprescription, applauding hospitals that complied, and publicly shaming those that flouted its new protocols. Now there’s evidence the plan is working. A new study by doctors at Zhejiang University reports that the percentage of hospitalized patients who were prescribed antibiotics fell from 68 percent in 2011 to 58 percent by the end of 2012. For outpatients, that proportion dropped from 25 percent to 15 percent.

Data on hospital drug sales reflect this trend as well. Antibiotics procurement in Tianjin, for example, was 200 million yuan ($32 million) less in 2011 than in 2010, despite upticks in both hospitalizations and outpatients. This chart from IMS research showing how the value of antibiotics (antimicrobials) sold, as a proportion of overall drug sales, has changed:

"Changes in Chinese Policies to Promote the Rational Use of Antibiotics," Xiao et al.

We’re not out of the woods yet, though. The authors of the Zhejiang University study note that most Chinese medical students aren’t taught the relationship between antibiotics use and superbugs. And since the government only provides 20 percent of their funding, hospitals are still dependent on drug sales for profits. Plus, a big cause of antibiotic resistance is the drugs’ over-use not just on people, but on millions of farm animals. And that’s an area over which the health ministry has no say.

Gwynn Guilford is a reporter and editor for Quartz.

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