Availability of benzathine penicillin G for syphilis treatment in Shandong Province, Eastern China

• Published in: BMC health services research Vol. 19; no. 1; p. 188
• Main Authors: Chen, Xinlong, Li, Guigang, Gan, Yanling, Chu, Tongsheng, Liu, Dianchang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 22-03-2019; BioMed Central; BMC
• Subjects: Allergies; Analysis; Anti-Bacterial Agents - supply & distribution; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics; Availability; Benzathine penicillin G; Child health; Childrens health; China; Data collection; Disease; Disease prevention; Disease transmission; Drug dosages; Drug therapy; Family planning; Health care reform; Health care services accessibility; Health facilities; Health services; Hospitals; Humans; Infections; Maternal & child health; Medicine; Penicillin; Penicillin G; Penicillin G benzathine; Penicillin G Benzathine - supply & distribution; Penicillin G Benzathine - therapeutic use; Penicillins; Physicians; Pregnancy; Public hospitals; Questionnaires; Sexually transmitted diseases; Shortages; Statistical analysis; STD; Supply and demand; Surveys and Questionnaires; Syphilis; Syphilis - drug therapy; Tetracyclines; Womens health; China; Availability; Benzathine penicillin G; China; Syphilis
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-019-4006-4

The shortage of benzathine penicillin G (BPG) worldwide presents a major challenge in the treatment of syphilis. Its availability for syphilis treatment has not been adequately evaluated in China.
Two surveys were conducted among hospitals providing sexually transmitted infection clinical services in Shandong Province in 2012 and 2018. Data on the basic information and BPG availability of the surveyed hospitals and related factors were collected and analyzed using SPSS 17.0.
A total of 433 and 515 hospitals were surveyed in 2012 and 2018, respectively. A significant difference in BPG availability was observed among different levels and types of hospitals both in 2012 (X
 = 9.747, p = 0.008; X
 = 37.167, p = 0.000) and 2018 (X
 = 11.775, p = 0.003; X
 = 28.331, p = 0.000). The BPG availability among surveyed hospitals increased from 45.0% in 2012 to 56.4% in 2018 (X
 = 11.131, p = 0.001). The BPG availability was higher in 2018 than in 2012 among county-level hospitals (52.0% vs. 40.8%, X
 = 7.783, p = 0.005), general western medicine hospitals (62.1% vs. 50.0%, X
 = 6.742, p = 0.009), maternal and child health hospitals (57.1% vs. 26.9%, X
 = 13.906, p = 0.000), and public hospitals (56.8% vs. 45.0%, X
 = 11.361, p = 0.001). However, the county-level availability of BPG (at least one hospital has BPG in a county-level unit) has not improved between 2012 and 2018 (65.93% vs. 70.34%; X
 = 0.563, p = 0.453). The absences of clinical needs, restriction of clinical antibacterial drugs, and lack of qualifications for providing syphilis treatment were the major reasons for the low BPG availability of hospitals.
BPG availability for syphilis treatment in Shandong Province remains low and presents disparities among different levels and types of hospitals, although it has been improved in recent years. The low availability of BPG for syphilis treatment in China is related to its clinical use by doctors rather than the market supply. Health care reforms should further improve the availability and accessibility of health services.