Antimicrobial resistance remains a significant concern, with global implications for public health. In rural areas with limited healthcare resources, poor oversight and irrational antibiotic prescribing exacerbate the issue. To address these challenges, the County Medical Community Central Pharmacy (CMCP) program introduced a multi-faceted intervention aimed at optimizing pharmacy services and antibiotic use in primary healthcare settings. This article reviews the impact of the CMCP program on antibiotic stewardship in rural institutions, revealing encouraging outcomes and potential for broad application in similar settings.
Study Design and Methods
Researchers conducted a multicenter quasi-experimental study across six diverse regions in Shandong Province, China. The study aimed to assess the CMCP program’s efficacy in mitigating antibiotic misuse. Conducted over six months from July to December 2023, 37 primary healthcare institutions participated, with 25 implementing the CMCP program and 12 serving as a control group. The impact of the program was evaluated through structured questionnaires and outpatient prescription reviews, analyzed using a difference-in-differences (DID) regression model.
Findings on Antibiotic Use
The intervention group showed a less pronounced increase in antibiotic usage rates compared to the control group (from 15.726% to 18.732% vs. 17.682% to 26.582%). Furthermore, the intervention group experienced a significant reduction in irrational antibiotic use, decreasing from 50.660% to 27.655%, while the control group saw negligible change. Analysis confirmed the program’s effectiveness in reducing unnecessary prescriptions, signaling an improvement in prescription rationality due to the CMCP initiative.
Key observations include:
- Rural primary healthcare institutions experienced more structured pharmacy practices with CMCP.
- Irrational antibiotic prescribing significantly reduced in implementation group.
- Central oversight and pharmacist collaboration regarded as critical components to program success.
- Operational and staff characteristics played a significant part in the outcomes.
Antimicrobial resistance remains a formidable challenge worldwide, particularly in resource-constrained settings. The CMCP program’s success underscores the potential of centralized oversight and institutional collaboration to enhance antibiotic stewardship. Such initiatives require commitment to training and supporting local healthcare providers. As these programs expand, they could serve as a model for other low-resource settings. The sustained impact of these interventions would depend on ongoing training, evaluation, and iteration based on data. Healthcare policy makers should consider these findings to guide policies that empower primary care institutions in managing antibiotic use effectively. This effort not only curbs resistance but ultimately improves overall health outcomes in these communities.
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