某院2016年—2018年抗菌药物临床使用及合理性分析

目的:分析医院抗菌药物临床使用现状,为临床抗菌药物合理使用提供参考。方法:抽取医院2016年—2018年抗菌药物临床使用资料,分析其销售金额、用药频度(DDDs)、日均费用(DDC)、构成比和各年度是否增长。结果:2016年—2018年3年间医院西药销售总金额分别为33594.71万元、32142.13万元和29692.84万元,其中抗菌药物金额分别为6385.39万元、6111.56万元和5777.92万元,抗菌药物销售金额占西药总金额平均为19.15%;抗菌药物金额年均下降4.87%;抗菌药物金额列第1、2位的分别为第3、2代头孢菌素类;DDDs列第1、2位主要为大环内酯类和第3代头孢菌素类;非限制和限制使用级抗菌药物销售金额构成比分别为17.14%和70.03%,其DDDs构成比分别为59.44%和38.44%;特殊使用级抗菌药物销售金额和DDDs下降明显;抗菌药物口服和注射剂型的销售金额约占20%和80%,其DDDs分别为69%和31%;单品种销售金额列前3位为头孢替安、头孢硫脒、哌拉西林钠-他唑巴坦钠和头孢哌酮-舒巴坦钠;单品种DDDs列前3位的为克拉霉素、头孢克肟、头孢羟氨苄。结论:医院抗菌药物临床使用较为规范、合理,但抗菌药物规范化管理任重道远,应持之以恒、持续改进。

Analysis on Clinical Usage and Its Rationality of Antimicrobial Agents in a Hospital from 2016 to 2018

Objective:To analyze the status of clinical usage of antimicrobial agents in a hospital,and to provide a reference for the rational medication of clinical antimicrobial agents.Methods:Data on the clinical usage of antibacterial drugs in a hospital from 2016 to 2018 were extracted to analyze the sales amount,drug use frequency(defined daily doses,DDDs),average daily cost(defined daily cost,DDC),composition ratio and any annual growth.Results:During the 3 years from 2016 to 2018,the total amount of Western medicine sold in hospitals was 335.9471 million yuan,321.4213 million yuan and 296.9284 million yuan,among which the amount of antibacterial drugs was 63.8539 million yuan,61.1156 million yuan and 57.7792 million yuan,accounting for 19.15%of the total amount of western medicine on average.The amount of antibacterial drugs decreased by 4.87%annually.The first and the second in the list of the amount of antibacterial drugs were the cephalosporins of the third and second generation.The first and second positions in DDDs were macrolides and the third generation cephalosporins.The sales amount of unrestricted and restricted use grade antibiotics were 17.14%and 70.03%,respectively,and the DDDs component ratio was 59.44%and 38.44%,respectively.The sales amount and DDDs of special use antibiotics decreased obviously.The sales volume of oral and injection dosage forms of antibiotics accounted for about 20%and 80%,with 69%and 31%of DDDs,respectively.The TOP 3 sales values of a single variety were cefotiam,cefatiamidine,piperacillin sodium-tazobactam sodium and cefoperazone sodium sulbactam sodium;The TOP 3 DDDs varieties were clarithromycin,cefoxime and cefadroxil.Conclusion:The clinical usage of antimicrobial drugs in the hospitals is relatively standardized and reasonable,but the standardized management of antimicrobial drugs is a long way to go,which should be persistent and make continuous improvement.