ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026
A multi-site observational study of rationality assessment for carbapenem use in China: carbapenem stewardship opportunities.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionCarbapenems are key antibiotics for treating severe infections caused by Gram-negative bacteria. However, the irrational use of carbapenems has raised serious concerns regarding the emergence of carbapenem-resistant organisms. This study aimed to assess the rationality of carbapenem use and to identify opportunity of improvement.
methodsA multi-site, observational, retrospective study was conducted in 10 hospitals in Sichuan, China. All emergency and hospitalized patients treated with carbapenems between November 1 and December 31, 2021, were included. The rationality of carbapenem use was evaluated from three aspects: necessity for empiric treatment, appropriateness for targeted therapy, and optimization for the regime.
resultsA total of 138,092 cases were screened and 2,028 received a carbapenem, corresponding to an overall use rate of 1.5%. There were 1,908 cases eligible for assessment comprising 1,729 (90.6%) empiric and 179 (9.4%) targeted treatment. Unnecessary use was identified in 502 cases (29.0%) with empiric treatment, most of which used irrationally for mild to moderate infections. Inappropriate use was found in 58 (32.4%) receiving targeted therapy, mostly because of treating infections with other recommended options (n = 49). Optimization issues were uncovered in 256 (13.4%) of 1,908 cases, commonly due to lack of microbiological testing or improper dose adjustment.
conclusionA considerable proportion of carbapenem use in the participating hospitals was irrational. Carbapenem stewardship on avoiding unnecessary use in mild/moderate infections and inappropriate applications in those with other recommended options, improving microbiological testing, and optimizing dosage regimens are needed to promote rational carbapenem use.
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