National Health Commission: further strengthen the management of antimicrobial drugs, to deal with microbial resistance
2021-05-02
Based on the problem of microbial drug resistance which is highly concerned by the society at present, the Notice puts forward specific requirements from five aspects. First, we should fully understand the importance of antimicrobial drug management, and require all localities to attach great importance to antimicrobial drug management, and continue to do a good job of work deployment and responsibility implementation. Second, promote overall deployment, comprehensively strengthen the management of antimicrobial drugs, require all localities to standardize the clinical diagnosis and treatment of infectious diseases, carry out targeted theoretical and practical training, medical institutions should adjust and optimize the supply list of antimicrobial drugs; Three is to perfect management measures to further improve the level of rational drug use, ask around to the rational use of antimicrobial drugs in hospital evaluation, public hospital performance evaluation, assessment of the rational use of drugs, such as work, to further increase the clinical application of antibacterial drugs surveillance network, bacterial drug resistance monitoring network access number of medical institutions, a pilot study on antimicrobial drug susceptibility in vitro fold point; Fourth, based on multidisciplinary cooperation, improve the ability of diagnosis and treatment of infectious diseases, require medical institutions to strengthen the construction of infectious diseases department, implement personalized evidence-based prevention and control measures for important clinically drug-resistant microorganism infection, give priority to training clinical pharmacists in the field of anti-infection, and standardize the skin test of β-lactam drugs. Fifth, strengthen publicity and guidance, improve the public awareness of rational drug use, require local governments to focus on the publicity of the misuse of antimicrobial drugs and the harm of irrational use of antimicrobial drugs, establish a regular publicity mechanism for the rational use of antimicrobial drugs, and effectively improve the public awareness of the rational use of antimicrobial drugs.

Notice of the National Health Commission on Further Strengthening the Management of Antimicrobial Drugs to Constrain Drug Resistance

Guowei Medical Han [2021] No. 73

Health Commission of provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps:

In order to further strengthen the management of antimicrobial drugs, actively respond to microbial resistance, continue to improve the level of clinical rational drug use, and protect people's health, the following work requirements are proposed:

First, fully understand the importance of antimicrobial drug management

At present, the international community is highly concerned about the problem of microbial resistance, especially in the context of the global spread of COVID-19, it is particularly important to strengthen the management of antimicrobial drugs. The World Health Organization has repeatedly called for the rational use of antimicrobial drugs to better respond to the challenges posed by the epidemic. International conferences such as the United Nations General Assembly and the G20 Summit have listed microbial resistance as an important topic to be studied and discussed at a higher level. Local governments should attach great importance to the management of antimicrobial drugs, take the management of antimicrobial drugs as an important part of protecting public health, preventing biosafety risks and promoting social harmony and stability, and continue to do a good job in the planning and implementation of responsibilities. Health administrative departments should take the responsibility of guiding and supervising the management of antimicrobial drugs, and medical institutions should take the main responsibility of rational use of antimicrobial drugs, and take solid and effective measures to reduce the irrational use of antimicrobial drugs.

II. Promote overall deployment and comprehensively strengthen antimicrobial drug management

All localities should further regulate the drug treatment of infectious diseases caused by pathogenic microorganisms such as bacteria, mycoplasma, chlamydia, rickettsia, spirochetes and fungi in accordance with the relevant requirements of the Administrative Measures for Clinical Application of Antimicrobial Agents. At the same time, we will make overall plans to promote the clinical diagnosis and treatment of infectious diseases caused by Mycobacterium tuberculosis, parasites and various viruses, and establish and improve relevant disease diagnosis and treatment norms, technical guidelines, clinical pathways, guiding principles for clinical application of drugs and monitoring index systems. To various clinical physicians and clinical pharmacists, microbial inspection personnel to carry out targeted training theory and practice, strengthening clinical reasonable application of antimicrobial drugs, regulating the experience administration, reduce no indications the use of antimicrobial drugs, further enhance the level of standardized diagnosis and treatment of infectious diseases and slow the microbial resistance. Medical institutions should scientifically adjust and optimize the supply list of antimicrobial drugs of their own institutions in accordance with regulations, and manage the rational use of antimicrobial drugs from the source of procurement.

3. Improve management measures and further improve the level of rational drug use

Local health administrative departments at all levels should include the rational use of antimicrobial drugs in hospital evaluation, performance evaluation of public hospitals and rational drug use evaluation, and appropriately increase the assessment weight to play the baton role. We will further increase the number of medical institutions in the national monitoring network for clinical application of antimicrobial drugs and the monitoring network for bacterial resistance (hereinafter referred to as the "two networks"), and give full play to the monitoring and supervision role of the "two networks". By the end of September 2021, all secondary and above general hospitals should join the "two networks"; Encourage other secondary and above medical institutions to join the network; We will actively explore ways and methods for primary medical institutions to enter the network. Newly enrolled medical institutions should strengthen leadership and support and actively create conditions for monitoring work. Make full use of information means to collect, statistic and analyze relevant data, strengthen monitoring and supervision, continuously evaluate the management effect, and take targeted intervention measures to improve the level of drug use. To carry out in vitro susceptibility folding point research of antimicrobial drugs on a pilot basis, and gradually establish a standard system of folding point of antimicrobial drugs in China, so as to guide scientific and accurate clinical medication.

Fourth, based on multidisciplinary cooperation, improve the ability of diagnosis and treatment of infectious diseases

To improve the outcome of infectious diseases and improve the quality of medical treatment, medical institutions should strengthen the construction of infectious diseases departments, and do a good job in the cooperation of infection prevention and control, inspection, pharmacy, nursing and other disciplines, and jointly formulate and implement infectious disease diagnosis and treatment norms and clinical pathways. The whole hospital should be urged to implement basic measures for infection control, and individualized evidence-based prevention and control measures for clinically important drug-resistant microorganism infections should be implemented according to the epidemiological characteristics of drug-resistant microorganism in the institution. Microbiology laboratory takes the initiative to communicate with clinical departments to improve microbiological testing projects, carry out corresponding etiological tests, and improve the diagnostic level of infectious diseases. Priority should be given to training clinical pharmacists equipped with anti-infection field, and clinical pharmacists should actively participate in anti-infection treatment, implement prescription review and comment requirements, and promote rational use of antimicrobial drugs. To standardize the skin test of β-lactam drugs and optimize the antibacterial drug use structure. Do a good job of quality nursing services, timely observation of patients' condition changes, reduce the complications of infection.
5. Strengthen publicity and guidance to raise the public's awareness of rational drug use

Health administrative departments and medical institutions at all levels should strengthen the publicity of rational drug use, focus on the publicity of misconceptions in the use of antimicrobial drugs and the harm of irrational use, correct patients' non-standard self-treatment behaviors, and guide them to rational use of antimicrobial drugs under the guidance of doctors and pharmacists. Establish a regular publicity mechanism for the rational use of antimicrobial drugs, and carry out publicity activities with the World Health Organization every year to promote the effective transmission of correct information. The management of antimicrobial drugs should be integrated into the daily management work to effectively improve the public's awareness of the rational use of antimicrobial drugs.

Medical institutions incorporated into the "two networks" as required shall log in to the "two networks" in time to submit applications for access. National Antimicrobial Clinical Application Monitoring Network: http://y.chinadtc.org.cn; National Bacterial Drug Resistance Monitoring Network Website: www.carss.cn. The Commission will keep us informed of the progress of relevant work in due course.