To characterize the decadal trends in antibiotic use among hospitalized patients in China, and to project consumption trajectories through 2030. We analyzed quarterly data on inpatient antibiotic use from the Centre for Antibacterial Surveillance between 2013 and 2024, with consumption quantified as defined daily doses per 100 patient-days (DDDs/100 PDs). The analyses examined national trends by WHO Access, Watch, and Reserve (AWaRe) categories, and identified the 10 most-consumed antibiotics. A spatiotemporal mixed-effects model was applied to estimate long-term trends and pandemic-related effects and produced regional and hospital-level forecasts of antibiotic consumption through 2030. Point estimate and 95% Credible Intervals (CrIs) were reported. National inpatient antibiotic consumption declined steadily from 46.8 to 35.3 DDDs/100 PDs over the study period (annual percentage trend: -0.8; 95% CrIs: -0.9 to -0.6), with no significant long-term deviation attributable to COVID-19 pandemic. The overall decline was mainly driven by decreased use of Access antibiotics with an average annual percentage of 4.3% (95% CrIs: -6.1% to -2.4%), while Watch and Reserve antibiotics increased. Antibiotic selection became more concentrated, with the top 10 antibiotics accounting for 66.0% of total consumption in 2024, up from 46.7% in 2013. By 2030, overall antibiotic consumption is projected to decline by 11.4% from 2019 levels, mainly owing to reductions in Access antibiotic use. The shift away from Access antibiotics toward a narrow preference for a limited number of broad-spectrum drugs prone to promote resistance highlights the need to strengthen stewardship programs adapted to local epidemiology of resistance patterns.
Li et al. (2026) studied this question.