Objective  To systematically review the incidence of antibiotic-associated diarrhea (AAD) in critically ill patients in China, and to provide evidence-based basis for the rational use of antibiotics.

Methods   PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang Data, VIP and SionMed databases were electronically searched to collect studies on the incidence of AAD in acute and critically ill patients in China from inception to April 23, 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 17.0 software.

Results  A total of 50 studies involving 26,512 subjects were included. Meta-analysis results showed that the incidence of AAD in critically ill patients in China was 26.5% [95%CI (22.9%, 30.1%)]. Subgroup analysis showed that the incidence of AAD in critically ill children in China was 40.6% [95%CI (30.7%, 50.4%)], and in critically ill adults in China was 18.7% [95%CI (16.1%, 21.4%)], among which the incidence of AAD in children in East China and adults in Southwest China was the lowest. The incidence of AAD in children and adults in Northeast China was the highest.

Conclusion  The incidence of AAD in critically ill patients in China is relatively high, and it is necessary to carry out effective intervention measures, such as rational selection and standardized use of antibiotics, early prevention and detection of AAD occurrence, to reduce the medical burden caused by AAD in critically ill patients and improve the quality of prognosis.

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