Strategic measures for the control of surging antimicrobial resistance in Hong Kong and mainland of China

Cheng, Vincent CC; Wong, Sally CY; Ho, Pak-Leung; Yuen, Kwok-Yung

Antibiotic consumption in the community was strongly associated with an increase in antibiotic resistance. In a recently published meta-analysis on the relationship between the antibiotic resistance patterns of bacteria circulating in the community and the consumption of antibiotics in the community, it was shown that increased antibiotics not only produce greater antimicrobial resistance at the level of individual patients, but may also produce greater resistance in the community as a whole. 73 Antibiotic consumption increased by 36% (from 54 billion standard units to 73.6 billion standard units) between 2000 and 2010 according to the drug sales data in 71 countries. Brazil, Russia, India, China and South Africa accounted for 76% of this increase. 74 Education for physicians in private care is an important strategy for controlling antibiotic use (Table 1 ). In a study using mixed qualitative and quantitative evaluation of a randomized controlled communitywide educational intervention in 16 Massachusetts communities, physicians in the intervention communities received locally endorsed guidelines, group educational sessions, and biweekly newsletters. Physicians in the intervention arm reported decreased antibiotic prescription from 2000-2003 compared with control physicians (75% vs. 58%, P50.03). 75 Moreover, patient and parent education that aims to enhance knowledge and awareness about antibiotic resistance and appropriate antibiotic use is equally important.