抗菌药物广泛使用是许多国家日益增长的抗菌药物耐药性问题的根源。在中国，什么是抗菌药物过多使用的关键动因，目前尚缺乏深入而系统的研究，而人们对农村及医院以外的抗菌药物使用状况则知之更少。本项目旨在通过一系列定性和定量研究，系统而深入地了解影响安徽农村地区抗菌药物使用的关键社会、经济、文化及体制因素。项目将系统描述和分析：居民发生感染时的自我保健及就医行为；基层医疗及药品零售机构针对常见感染的诊断、检验及抗菌药物使用过程；常见呼吸道感染的发病率及影响因素；不同保健措施（包括抗菌药物使用）对感染病程及严重程度的作用；开展临床诊断准确性评价的可行性；患者自述症状与临床诊断的关系；非住院患者的抗菌药物耐药性水平以及现有耐药性监测数据的偏倚。项目将依据这些信息制定合理的干预政策与措施，以帮助安徽及中国其他地区优化抗菌药物使用，在有效控制使用的同时保障居民对必要的抗菌药物的可得性。

Widespread antibiotic use is considered to be a major contributor to the growing problem of antimicrobial resistance in many countries, but there is a lack of evidence regarding its key drivers in China, particularly in rural settings and outside hospitals, and whether these differ from those found elsewhere. This evidence is essential for identifying the health system, behavioural and policy interventions that have most potential for limiting the spread of antibiotic resistance in China, while ensuring equitable access to antibiotics for essential treatment of bacterial infections. This innovative interdisciplinary project aims to acquire greater understanding of key social, economic, cultural, systemic and other influences on antibiotic use by investigating and quantifying current use of both prescribed and non-prescribed antibiotics and other forms of care to treat common infections in rural parts of Anhui Province. Our study will document treatment-seeking practices for selected common infections from all sources (including informal, Traditional Chinese Medicine (TCM), folk, home-based, private and government medical care) among patients at local health facilities and in the general population. We will gather information on testing, clinical diagnosis and antibiotic treatment procedures at lower levels of the health system and on over-the-counter purchasing of antibiotics from pharmacies and medicine shops. We will ascertain the annual incidence of common respiratory tract infections in the population of Anhui Province and assess the effects of the different forms of treatment they use, including antibiotics, on reported severity and duration of illness. We will also ascertain the feasibility of assessing clinical diagnostic accuracy, relationship between patient-reported symptoms and clinical diagnosis, and burden of antibiotic resistance in non-hospitalised patients, and investigate possible population biases in existing laboratory data through microbiological sampling. This range of evidence will enable us to formulate recommendations for appropriate interventions to optimise the use of antibiotics in Anhui Province and other regions of China.