武汉地区34家医院2007~2014年碳青霉烯类药物应用情况分析

摘 要 目的：了解武汉地区碳青霉烯类药物的应用及趋势。方法: 对武汉地区34家医院2007～2014年碳青霉烯类药物的销售金额、用药频度（DDDs）和日均费用（DDC）等进行回顾性统计分析。结果: 武汉地区碳青霉烯类总销售金额逐年增长，2014年较2007年增长4倍。比阿培南销售金额增长迅速，自2009年来，临床以美罗培南、亚胺培南/西司他丁、比阿培南三种注射剂为主导，唯一口服品种法罗培南为辅助；各碳青霉烯类药物的DDDs变化规律与销售金额基本一致；所有碳青霉烯类药物的DDC，注射剂型呈逐年下降趋势，降幅以比阿培南最大，但仍居第一位，美罗培南、亚胺培南/西司他丁各年度DDC均超过400元，法罗培南2007～2009年价格波动较大，2009年增加两倍至453元后保持稳定。结论:2011年抗菌药物专项整治措施对抗菌药物遴选起到一定的规范作用；当前该类药物品种合理，但患者经济负担较大。建议继续加强抗菌药物的监管力度，控制药物成本，保障用药合理安全。

Utilization Analysis of Carbapenems in 34 Hospitals of Wuhan Area during 2007-2014

ABSTRACT Objective: To investigate the application and tendency of carbapenems in the hospitals of Wuhan area. Methods: The application of carbapenems in 34 hospitals of Wuhan area during 2007 2014 was analyzed statistically in terms of consumption sum, DDDs, DDC and so on. Results:The total consumption sum of carbapenems increased year by year. Compared with that in 2007, the total consumption sum increased by 4 fold in 2014. The growing rate of total consumption sum of biapenem was the fastest among various varieties. Since 2009, three injections including meropenem, biapenem and imipenem / cilastatin predominated the market of Wuhan area, followed by faropenem with oral administration. The changing trend of DDDs was basically consistent with the total consumption sum. DDC of all the drugs was relatively high and demonstrated decreasing tendency, and that of biapenem decreased most notably, while still ranked the first place. DDC of meropenem and imipenem/cilastatin both exceeded 400 yuan. The price of faropenem fluctuated notably during 2007 2009, while increased by 2 fold in 2009 (453 yuan) and then remained stable. Conclusion:The special rectification measures show positive impact on the selection of antimicrobial agents in Wuhan area. The drug varieties are proper, while the average daily cost is still high. The government should continue to strengthen the management of antibiotics to ensure the rational use of carbapenems.