Objective  To investigate antibiotic use among hospitalized chronic obstructive pulmonary disease (COPD) patients with acute exacerbation in Pudong New Area of Shanghai city and to provide references for reasonable antibiotic use in clinic practice.

  Methods  We selected two tertiary hospitals in Pudong New Area of Shanghai as study sites using convenient sampling and then 3 000 COPD inpatients in the two hospitals were randomly selected from January 1, 2014 to January 1, 2017. The information on antibiotics use of the inpatients were extracted from their medical records.

  Results  From all the inpatients selected, 1 784 were diagnosed with acute exacerbation, of which 920 (51.57%) were male and 864 (48.43%) were female, with a mean age of 77.5 ± 12.4 years. Cephalosporins were the most frequently used antibiotics among the COPD inpatients with acute exacerbation and the case times of administration of cephalosporins were 5 891, accounting for 46.82% of total case times of antibiotic use. The most frequently used antibiotic was cefoperazone/sulbactam, with a total case times of administration of 875 and accounting for 6.95% of total case times of administration (875/12 581). The maximum drug utilization index for the antibiotics used was 2.06 for levofloxacin and the minimum was 0.49 for linezolid. The applied antibiotics with the drug utilization index close to 1.00 included ceftizoxime sodium (0.91), imipenem/cilastatin sodium (0.99), rifampicin (0.99), ciprofloxacin (1.08), and biapenem (1.10).

  Conclusion  Antibiotic use is reasonable among COPD inpatients with acute exacerbation in Pudong New Area of Shanghai city but still needs to be improved for more rational antibiotic use in clinical practice.