The Ministry of Health says it will enforce a strict regulation designed to curb the widespread overuse of antibiotics by doctors and hospitals this year amid concerns of an increase in drug-resistant diseases. The rule, to take effect on August 1, classifies antibiotics into three categories - restricted, unrestricted and those under special management - based on their safety, effectiveness, drug resistance factors and price. The overuse of antibiotics is common on the mainland, with doctors often getting bigger kickbacks for prescribing them. Some doctors also tend to rely on powerful antibiotics to achieve quick and effective cures, so they can avoid the risks of prolonged treatment or conflicts with patients, but such actions exacerbate drug resistance. It also leads to an increase in drug-resistant illnesses. Professor Xiao Yonghong from Zhejiang No1 People's Hospital, the director of the ministry's national drug-resistant bacteria surveillance network, said: 'Drug resistance, mainly because of using unnecessary and excessive antibiotics, is jeopardising public health around the world. Many diseases that could be treated with low level antibiotics will come back and that will be catastrophic.' The rule says doctors and pharmacists will need to receive training and pass a test before being allowed to prescribe such drugs. Antibiotics will only be prescribed after the approval of the hospital drug affairs committee and doctors will be held directly responsible for overuse. The overuse of antibiotics will be an important factor when evaluating hospitals, the rules says, indicating that those who prescribe too many antibiotics could be demoted. Doctors found overprescribing three times will be warned and their access to prescriptions will be restricted. They will lose prescription rights completely if found to be profiting from the overuse of antibiotics. The ministry has issued many directives on the use of antibiotics and has pushed hospital management to limit their use. In April last year, it launched a three-year campaign making hospital chiefs ultimately accountable. Wang Yu, director of the ministry's medical administration department, said an inspection of 430 hospitals found the campaign had been effective. He said the use of antibiotics in outpatient services dropped from 27.8 per cent of cases in 2006 to 15 per cent last year, while in inpatient services it fell from 80.5 to 58 per cent. Hospitals were asked to limit the use of antibiotics to less than 20 per cent of outpatient cases and less than 60 per cent of inpatients. Xiao said the ministry had not set high standards. Antibiotic use in some developed countries was below 40 per cent in inpatient services and 10 per cent in outpatients. The World Health Organisation recommends an average of 30 per cent. Xu Xiaoyuan, dean of Peking University Medical Science Centre's department of infectious diseases, said the campaign had benefited, with the control of antibiotic use now part of daily management at hospitals.