Pathways to optimising antibiotic use in rural China: Identifying key determinants in community and clinical settings, a mixed methods study protocol
Date
2019-08-10Author
Zhao, Linhai
Kwiatkowska, Rachel Marie
Chai, Jing
Cabral, Christie
Chen, Meixuan
Bowker, Karen
Coope, Caroline
Shen, Jilu
Shen, XingRong
Cheng, Jing
Feng, Rui
Kadetz, Paul
MacGowan, Alasdair
Oliver, Isabel
Hickman, Matthew
Wang, Debin
Lambert, Helen
Metadata
Show full item recordCitation
Zhao, L., Kwiatkowska, R.M., Chai, J., Cabral, C., Chen, M., Bowker, K., Coope, C., Shen, J., Shen, X., Cheng, J., Feng, R., Kadetz, P., MacGowan, A., Oliver, I., Hickman, M., Wang, D. and Lambert, H. (2019) ‘Pathways to optimising antibiotic use in rural China: Identifying key determinants in community and clinical settings, a mixed methods study protocol’, BMJ Open, 9(8), article no. e027819.
Abstract
Introduction This study aims to investigate patterns
of antibiotic treatment-seeking, describe current levels
of and drivers for antibiotic use for common infections
(respiratory tract and urinary tract infections) and test the
feasibility of determining the prevalence and epidemiology
of antimicrobial resistance (AMR) in rural areas of Anhui
province, in order to identify potential interventions to
promote antibiotic stewardship and reduce the burden of
AMR in China.
Methods and analysis We will conduct direct
observations, structured and semistructured interviews
in retail pharmacies, village clinics and township health
centres to investigate treatment-seeking and antibiotic
use. Clinical isolates from 1550 sputum, throat swab
and urine samples taken from consenting patients at
village and township health centres will be analysed
to identify bacterial pathogens and ascertain antibiotic
susceptibilities. Healthcare records will be surveyed for a
subsample of those recruited to the study to assess their
completeness and accuracy.
Ethics and dissemination The full research protocol
has been reviewed and approved by the Biomedical
Ethics Committee of Anhui Medical University (reference
number: 20170271). Participation of patients and doctors
is voluntary and written informed consent is sought
from all participants. Findings from the study will be
disseminated through academic routes including peerreviewed publications and conference presentations, via
tailored research summaries for health professionals,
health service managers and policymakers and through
an end of project impact workshop with local and regional
stakeholders to identify key messages and priorities for
action.