2010—2012年兖矿集团总医院抗菌药物应用分析

目的：了解我院抗菌药物应用情况及趋势,考察开展抗菌药物专项整治活动效果。方法：采用回顾性调查方法,对2010—2012年我院各年上半年同期使用抗菌药物各项数据进行统计、分析。结果：抗菌药物销售金额2012年上半年比2011年上半年下降了19.82%,抗菌药物销售金额占药品总销售金额的比例3年下降了38.59%。抗菌药物销售金额最多的剂型是注射剂型,约占83%,口服剂型约占15%,其他剂型约占2%。门诊患者抗菌药物销售金额占抗菌药物总销售金额的25%,病房患者抗菌药物销售金额约占抗菌药物总销售金额的75%。2012年上半年与2011年上半年相比,门诊抗菌药物使用强度（AUD）下降了10.03%,病房AUD下降了44.14%。β-内酰胺类药销售金额占抗菌药物总销售金额比例最高,其中第1代头孢菌素销售金额增长较快;林可酰胺类药、咪唑衍生物类药销售金额下降明显。由用药频度（DDDs）排序可见,大环内酯类药、第3代头孢菌素的DDDs排序居前列,硝基呋喃衍生物DDDs增长迅速;碳青霉烯类、糖肽类药的DDDs稳步上升,说明严重感染和多重耐药菌感染逐渐增多。2012年注射用抗菌药物销售金额排序居前3位的药品为：头孢硫脒、氨曲南、五水头孢唑林;口服抗菌药物销售金额排序居前3位的药品为：硝呋太尔、头孢克肟、克拉霉素。结论：抗菌药物专项整治活动取得了明显效果,但我院在抗菌药物应用管理方面还存在一些不足。

Analysis of Antibiotic Use in Yankuang Group General Hospital During 2010-2012

OBJECTIVE ： To analyze the status quo and tendency of the utilization of antibiotics in our hospital and evaluate the efficacy of special intervention on antibiotic use. METHODS： By a retrospective survey, the consumption data of antibiotics in our hospital in the first half of each year from 2010 to 2012 were analyzed statistically. RESULTS ： The consumption sum of antibiotics in 2012 decreased by 19. 82% as compared 2011, and the proportion of antibiotics in total decreased by 38.59% over 3 years in terms of consumption sum. The consumption sum of antibiotics for injections were the highest, accounting for about 83% , followed by oral antibiotics （about 15% ） and other dosage forms of antibiotics （ about 2% ）. Antibiotics accounted for 25% in outpatient department vs. 75% in inpatient department in terms of consumption sum. AUD （antibiotics use density） decreased by 10.03% in outpatient department vs. AUD decrease of 44. 14% in inpatient department in 2012 as compared with 2011. Of all the antibiotics used, Beta-laetam drugs showed highest proportion in terms of consumption sum. The consumption sum ofthe first generation cephalosporins witnessed rapid increase, yet that of lincomycins and imidazole derivatives showed significantly decrease. In terms of DDDs, macrolides and the third generation cephalosporins topped the list and the DDDs of nitrofuran derivatives witnessed rapid increase. Carbapenems and glycopeptides showed stable increase in DDDs, which is suggestive of gradual increase in serious infection cases and muhidrug resistant infection cases. The top three antibiotics for injections in 2012 ranked by consumption sum were cefathiamidine, aztreonam and Cefazolin Sodium Pentahydrate for Injection and the top three oral antibiotics in 2012 were nifuratel, cefixime and clarithromycin. CONCLUSION： The special intervention on antibiotic use has achieved remarkable efficacy, but there are some defects in the utilization and administration of antibiotics in our hospital.