2016-2018年焦作市第二人民医院特殊使用级抗菌药物的使用情况分析

目的 分析焦作市第二人民医院特殊使用级抗菌药物的使用现状，加强特殊使用级抗菌药物的临床应用管理，促进抗菌药物临床合理使用，有效遏制细菌耐药。方法 采用回顾性分析方法，随机抽取焦作市第二人民医院2016-2018年特殊使用级抗菌药物的销售金额、用药频度（DDDs）、日均费用（DDC）及排序比（B/A）等进行统计分析。结果 特殊使用级抗菌药物的销售金额和构成比逐年升高；碳青霉烯类抗菌药物的销售金额最高，2016、2017年比阿培南的销售金额位居第1位，2018年亚胺培南/西司他丁的销售金额位居第3位，美罗培南的销售金额位于第1位。2016年特殊使用级抗菌药物中比阿培南、美罗培南、亚胺培南/西司他丁、万古霉素、伏立康唑的DDDs排在前5位；2017年比阿培南、美罗培南、亚胺培南/西司他丁的DDDs基本保持稳定，位居前3位。DDC值最高的是米卡芬净，其次是替加环素。比阿培南连续两年的B/A为1。特殊使用级抗菌药物存在选药不适宜、用法用量不适宜、药物配伍不当、联合用药不适宜等问题。结论 2016-2018年焦作市第二人民医院特殊使用级抗菌药物的使用整体呈逐年上升趋势，存在用药不合理现象，需要继续加强管理和药学干预，推进抗菌药物合理使用。

Analysis on use of special class antibiotic drugs in the Second People's Hospital of Jiaozuo from 2016 to 2018

Objective To analyze the current situation of the use of special class antibiotic drugs in the Second People''s Hospital of Jiaozuo from 2016 to 2018, to strengthen the clinical application management of special class antibiotic drugs, to promote the rational use of antimicrobial agents in clinic, and effectively contain bacterial resistance. Methods Consumption sum, frequency of drug use (DDDs), defined daily cost (DDC), and drug sequence ratio (B/A) of special class antibiotic drugs in the Second People''s Hospital of Jiaozuo from 2016 to 2018 were analyzed retrospectively. Results Consumption sum and constituent ratio of special class antibiotic drugs increased year by year. Consumption sum of carbapenem antibiotics was the highest. Consumption sum of biapenem in 2016 and 2017 was ranked the first. Consumption sum of imipenem/cilastatin in 2018 was ranked the third. Consumption sum of meropenem in 2018 was ranked the first. DDDs of biapenem, meropenem, imipenem/cilastatin, vancomycin, and voriconazole in 2016 were ranked the top five. DDDs of biapenem, meropenem, and imipenem/cilastatin in 2017 were basically stable, and they were ranked the top three. DDC of micafungin was the highest, followed by tigecycline. B/A of biapenem was 1 for two consecutive years. There were inappropriate choice of medicine, improper dosage and administration, improper drug compatibility, and inappropriate drug combination. Conclusion The utilization of special class antibiotic drugs in the Second People''s Hospital of Jiaozuo from 2016 to 2018 increased year by year on the whole, with the phenomenon of irrational drug use. So it is necessary to continue to reinforce the management and the pharmaceutical intervention to boost the fair use of antimicrobial agents.