Objective  To analyze the status and trend of clinical application of carbapenem antibiotics in grade A tertiary general hospitals in China between 2011 – 2014 for promoting rational clinical drug usage and the control of drug-resistant bacteria.

  Methods  We collected relevant data from the national surveillance network for clinical application of antibacterial drugs and all the clinically applied antibiotics were categorized according to Anatomical Therapeutic Chemical (ATC) classification codes recommended by World Health Organization (WHO). We examined clinical application of carbapenem antibiotics and economic burden in relation to the antibiotics usage.

  Results  The amount of carbapenem antibiotics clinically used and cost related to the usages increased by 17.67 % and 18.66 % in 151 grade A tertiary general hospitals across China during the period, with the highest increased rate for meropenem (> 50 %/per year). The clinically used carbapenem antibiotics with the largest amount and the highest cost is meropenem, followed by imipenem and cilastain. The carbapenem antibiotics with highest cost for defined daily dose is biapenem, followed by panipenem/betamipron. During the period, the clinically applied carbapenem antibiotics with the highest antimicrobial use density is meropenem for the hospitals in eastern and central regions of China, followed by imipenem and cilastain. The seasons with higher carbapenem antibiotics application are the first and the fourth quarter of a year for the hospitals in eastern, central and western regions and are the first and the third quarter of a year for hospitals in northeastern regions of China.

  Conclusions  The risk for the occurrence of drug resistance exists to some extent for tertiary general hospitals and hospitals in some key regions in China and supervision and management on clinical usage of carbapenem antibiotics should be strengthened for these hospitals.