Department of Health Sciences and Environment

Studentship 3: Antibiotic use and resistance in China

Infectious disease remains a major cause of illness and premature death, particularly in middle and low-income countries, and antimicrobial drugs are essential for treating this kind of disease. However, inappropriate use of antimicrobials is rapidly increasing the numbers, and widening the distribution, of microbes resistant to antimicrobial drugs. In China, the prevalence of some antimicrobial resistant strains consistently ranks amongst the highest worldwide, and the reported number of ineffective antibiotics is increasing. Antimicrobial resistance (AMR) is estimated to cause 700,000 deaths worldwide annually and, without urgent action, the number of global deaths due to AMR is projected to increase to 10 million by 2050.

The knowledge, attitudes and behaviours of a wide variety of stakeholders, including consumers, physicians and pharmacists, are critical factors that may contribute to the increase in AMR. In China, consumer behaviours that potentially contribute to AMR can include self-medication and under and over use of antimicrobial drugs, linked in turn to poverty and limited knowledge and the actions of physicians and pharmacists.

The aim of this studentship was to investigate the influences on behaviours with respect to the use of antibiotics and resistance across different stakeholders (parents, physicians and pharmacists) in China.

The studentship was held by Tingting Zhang, who was awarded a PhD in Health and Environment in July 2019 with two papers published:

Zhang T., Graham H., White P.C.L. Healthcare providers’ accounts of parental influence on their behaviour with respect to the use of antibiotics for children: a qualitative study in China. Journal of Community Medicine and Public Health Care 2018; 5: 036. https://pure.york.ac.uk/portal/en/publications/healthcare-providers-accounts-of-parental-influence-on-their-behaviour-with-respect-to-the-use-of-antibiotics-for-children(4d2d6e48-8e8a-4e05-b5ac-620811ec8c8f).html
Zhang T., Graham H., White P.C.L. Healthcare providers’ accounts of influences of antibiotic-related reforms on their behaviour with respect to the use of antibiotics for children: a qualitative study in China. Public Health Open Access 2018; 2: 000122. https://pure.york.ac.uk/portal/en/publications/healthcare-providers-accounts-of-influences-of-antibioticrelated-reforms-on-their-behaviour-with-respect-to-the-use-of-antibiotics-for-children(1c856a9d-8cd8-4e94-9e79-5097f3e7cc63).html

Currently Tingting Zhang works as a Research Associate in a UK-China AMR Hub in the University of Bristol, condiucting research to enhance the success of antibiotic resistance reduction strategies in China. Her contact email is tingting.zhang@bristol.ac.uk