• Hui Li, Yanhong Gong, Jing Han, Shengchao Zhang, Shanquan Chen, Xing Xu, Zuxun Lu, and Xiaoxv Yin.
• Department of Social Medicine and Health Management, School of Public Health, Huazhong University of Science and Technology, Wuhan, P. R. China.
• Clin. Infect. Dis. 2020 Jul 10.

BackgroundAfter implementing the 2011 national antimicrobial stewardship campaign, few studies focused on evaluating its effect in China's primary care facilities.MethodsWe randomly selected 11 community health centers in Shenzhen, China, and collected all outpatient prescriptions of these centers from 2010-2015. To evaluate the impact of local interventions on antibiotic prescribing, we used a segmented regression model of interrupted time series to analyze seven outcomes, i.e., percentage of prescriptions with antibiotics, and percentages of prescriptions with broad-spectrum antibiotics, with parenteral antibiotics, and with two or more antibiotics in all prescriptions or antibiotics-containing prescriptions.ResultsOverall, 1 482 223 outpatient prescriptions were obtained. The intervention was associated with a significant immediate change (-5.2%, P=.04) and change in slope (-3.1% per month, P<.01) for the percentage of prescriptions with antibiotics, and its relative cumulative effect at the end of the study was -74.0% (95% confidence interval, -79.0% to -69.1%). After the intervention, the percentage of prescriptions with broad-spectrum, and with parenteral antibiotics decreased dramatically by 36.7% and 77.3%, respectively, but their percentages in antibiotic-containing prescriptions decreased insignificantly. Percentage of prescriptions with two or more antibiotics in all prescriptions or antibiotics-containing prescriptions only showed immediate changes, but significant changes in slope were not observed.ConclusionsA typical practice in Shenzhen, China, showed that strict enforcement of antimicrobial stewardship campaign could effectively reduce antibiotic prescribing in primary care with a stable long-term effect. However, prescribing of broad-spectrum and parenteral antibiotics was still prevalent. More targeted interventions are required to promote appropriate antibiotic use.© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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