151家医院2003年度住院患者日抗菌药物使用率的调查分析

目的调查不同规模医院日抗菌药物使用情况。方法与全国医院感染现患率调查同时进行,调查2003年8月7日住院患者全身使用抗菌药物的情况,逐床查阅医嘱登记调查表,各医院汇总后统一分析。结果151家医院89539例住院患者的抗菌药物使用率为54.86%,治疗用药占48.98%,预防用药占35.44%,治疗加预防占15.58%。用1种抗菌药物占61.43%,2种33.65%,3种及以上4.92%。23.92%的治疗用药患者送标本做细菌培养。不同医院之间差别较大,教学医院抗菌药物使用率相对较低,300床位以下医院抗菌药物使用率明显高于300床位以上医院。呼吸科、综合ICU、儿科抗菌药物使用率较高。结论151家医院住院患者日抗菌药物使用率较高,预防用药较多,联合用药比例较大,培养标本送检率较低,提示仍需加强抗菌药物临床应用的管理。

Study on the frequency of antibiotics use per day among inpatients in 151 hospitals in 2003

Objective To investigate the antibiotics use in inpatients with hospitals under different scales. Methods On the day of August 7,2003,antibiotics use among inpatients were investigated,medical order to each inpatient was checked and forms were filled. Results Data showed that 54.86% of the 89 539 inpatients from 151 hospitals were using antibiotics,out of which 48.98% were used for therapeutic purposes while 35.44% for prophylaxis,and 15.58% for both therapy and prophylaxis. Among those who had received antibiotics, 61.43% received one, 33.65% received two and 4.92% received 3 or more agents. In patients who were on antibiotics for therapy,only 23.92% of the samples were sent for pathogens detection. The prevalence of antibiotics use was different among different hospitals, with teaching hospitals having the lowest and hospitals with less than 300 beds were higher than those with more than 300 beds. Departments of respiratory diseases,intensive care unit,and pediatrics had the higher use of antibiotics. Conclusion Inpatients in 151 hospitals had high prevalence of antibiotics use,especially for prophylaxis use but pathogen detection was seldomly done. It is necessary to strengthen the rational use and management of antibiotics use in the hospitals.