1170例住院患者抗菌药物使用情况分析

目的：了解我院抗菌药物应用现状和存在的问题,探讨抗菌药物的合理应用。方法：随机抽取2009年1～9月1170例出院患者病历,进行回顾性调查分析,记录每例患者姓名、性别、年龄、住院时间、原患疾病、手术类型、抗菌药物使用天数及使用种类、联合用药情况、用药指征、是否使用限制性抗菌药物、有无细菌感染证据或药敏实验结果及科内讨论等。结果：1170例出院患者中,抗菌药物平均使用率为66.15%,其中外科系统为81.12%;内科系统为51.20%。使用抗菌药物的患者中,预防用药380例,占49.09%,控制感染用药394例,占50.91%。给药方式以静脉给药为主;只用1种抗菌药物的有340例,占全部用药例数的43.93%,使用4种以上抗菌药物的有29人,占全部用药例数的3.75%;使用较多的为第3代头孢菌素类、青霉素类、氟喹诺酮类抗菌药物和抗厌氧菌药;用药时间小于7天的患者占46.38%;病原学送检率为32.43%。结论：部分患者存在抗菌药物使用送检率低、使用时间较长等不合理现象。应加强抗菌药物的监控,促进抗菌药物的合理应用。

Utilization of Antimicrobial Agents in 1170 Inpatients

OBJECTIVE： To analyze the status quo of the utilization of antimicrobial agents in our hospitial and discuss the rational use of antimicrobial agents. METHODS： The medical records of 1 170 patients discharged from our hospital from Jan. to Sep. in 2009 were sampled randomly for retrospective review with regard to patients’name,age and sex,length of hospital stay,original disease,type of surgery,duration of antibiotic use,category and combination of antibiotics,medication indications,whether there were application of restrictive antibiotics,whethere there were evidences of bacterial infection,results of drug sensitivity test and case discussions in department etc. RESULTS： Of the total 1 170 cases reviewed,66. 15% were found to have used antimicrobial agents （ the rate of antibiotic use for surgery systems was 81. 12% vs. 51. 20% for medicine systems）. 380 （49. 09% ） used antibiotics for preventive purpose and 394 （ 50. 91% ） for infection control. The antibiotics were mostly administered intravenously. 340 （43. 93% ） received only one kind of antibiotics and 29 （3. 75% ） received at least 4 kinds of antibiotics. The third generation cephalosporins,penicillins,quinolones and antianaerobic-microbacterial drugs were predominantly used. 46. 38% were treated with antibiotics for less than 7 days. The rate of etiological test was 32. 43% . CONCLUSION： The problems such as low rate of etiological test and prolonged use of antibiotics can still be seen. It’s urgent to tighten control on the monitoring of antibiotic use to promote rational use of antibiotics.