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Factors influencing antibiotic use in China |
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| Factor |
Influence |
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| Government policy |
By poorly remunerating doctors and expecting hospitals to support themselves largely through the sale of drugs, government policy encouraged over-prescribing of expensive drugs and discouraged quality assessment and improvement exercises. |
| Pharmaceutical industry |
By spending a large amount of money on drug advertising, gifts and financial "kick-backs" to doctors who prescribed their drugs drug companies encouraged excessive prescribing ("kick-backs" were particularly attractive given the low salary of hospital doctors). |
| Hospital Drug and Therapeutics Committees |
Generally regarded as ineffective; in particular they provided no monitoring of prescriptions and little independent education to medical staff. |
| Surgeons attitude and knowledge |
By being less interested in drugs than physicians ("operations were more important") misunderstandings were perpetuated such as, "new antibiotics are stronger"; "new drugs kill most germs"; "the bigger the operation, the greater the need for newer and stronger antibiotics". |
| Deteriorating relationship between doctors and patients |
This led to doctors protecting themselves from being sued by prescribing unnecessary &/or expensive drugs; this practice was often acerbated by media reports of patients physically assaulting the medical staff &/or extorting money from hospitals when treatment failed. |
Zhang and Harvey Australia and New Zealand Health Policy 2006 3:5 doi:10.1186/1743-8462-3-5 |
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