1543例住院患者抗菌药物临床应用横断面调查

目的:了解医院抗菌药物临床应用情况及其合理性。方法:采用横断面调查方法,对2012年12月14日全天所有住院患者进行抗菌药物使用调查。结果:1 543例住院患者中,抗菌药物横断面使用率为41.28%,其中单用率为75.82%,二联用药率为20.25%,三联及以上用药率为3.92%;在全院各科室中分院ICU使用率最高,为100%,其次为总院ICU以及内科综合病区,分别为95.45%和88.00%;全院治疗性用药病原学送检率达77.73%,ICU和儿科送检率最高,分别为100%和93.94%;预防性用药率为30.92%,其中围术期预防性使用抗菌药物为主要原因,占80.50%;使用频率列前5位的依次为β-内酰胺类/β-内酰胺酶抑制剂及其复合制剂、头孢菌素类、喹诺酮类、碳青霉烯类以及大环内酯类。结论:我院抗菌药物横断面使用率控制在一个合理水平,病原学检测率高,但存在联合用药率偏高、Ⅰ类切口用药率过高、围术期预防性使用抗菌药物给药时机不合理等情况,需要进一步完善监管制度与方法。

Cross Sectional Study on Clinical Application of Antibiotics in 1 543 Inpatients

OBJECTIVE： To investigate the cross sectional application and rationality of antibiotics. METHODS： A cross sec- tion investigation method was used to survey the application of antibiotics in 1 543 patients in Dec. 14th, 2012. RESULTS： The cross sectional utilization rate of antibiotics was 41.28% among 1 543 patients, specifically 75.82% for single drug, 20.25% for doublet, and 3.92% for triplet therapy. Among all departments, branch ICU had the highest usage rate （100%）, followed by whole ICU （95.45 % ） and general internal medicine department （88.00%）. The delivery rate of etiological examination for therapeu- tic medication was 77.73%, led by ICU （100%） and pediatrics department （93.94%）. The rate of prophylactic medication was 30.92%, mainly consisted of preoperative prophylactic application of antibiotics （80.50%）. The top 5 drugs in the list of frequency were β-lactams/β-lactamase inhibitor and compound, cephalosporins, quinolones, carbapenems, and macrolides. CONCLUSIONS ： The utilization rate of antibiotics maintains at a rational level with a high etiological examination rate. However, supervision system and method should be further improved because of high utilization rate of drug combination and antibiotics for type I incision, irra- tional medication timing for preoperative prophylactic application of antibiotics.