2010年中国740所医院住院患者抗菌药物日使用率调查

目的调查全国不同规模医院2010年抗菌药物日使用情况。方法采用横断面调查方法，全国不同规模740 所医院于2010年3月1日-12月31日期间对本院某一天住院患者的全身使用抗菌药物情况进行调查。结果740 所医院407 208例住院患者的抗菌药物日使用率为49.63%, 其中治疗性用药占49. 99%, 预防性用药占39.17%, 治疗+预防性用药占10.84%。在所有使用抗菌药物的患者中，单一用药占67.96%, 二联用药占30.08%, 三联及以上用药占1.96%。29.21%的治疗性用药患者送标本做细菌培养。不同医院之间抗菌药物日使用率差别较大,教学医院（46.98%）与非教学医院（50.31%）相比，抗菌药物日使用率相对较低(χ2=100.53，P=0.00)；床位数≥900、600～899、300～599、<300的不同规模医院抗菌药物日使用率分别为46.28%、47.54%、53.08%、60.28%，呈“阶梯式”升高(前后两两比较，分别χ2=571.90，P=0.00；χ2=579.38，P=0.00；χ2=36.11，P=0.00)。抗菌药物日使用率居前3位的科室为：儿科（85.50%）、综合重症监护室（81.95%）、呼吸科（76.99%）。结论740 所医院住院患者抗菌药物日使用率较高, 预防用药较多，联合用药比例较大, 病原学送检率较低, 提示仍需加强抗菌药物临床应用的管理。

National healthcare associated infection surveillance system point prevalence survey of antimicrobial use in 740 Chinese hospitals in 2010

Objective To investigate the antimicrobial use tn pauents at umc - 2010. Methods An one-day point prevalence survey on antimicrobial use in hospitalized patients was conducted with cros-sectional investigation method. Results The daily antimicrobial use rate in 407 208 inpatients at 740 hospitals was 49. 63%, 49. 99% of which were for therapeutic use, 39.17% for prophylaxis, and 10. 84% for both. of all patients receiving antimierobial agents, 67.96% received monotherapy regime, 30. 08% received two combined and l. 96% received three or more drug combined. 29. 2l % of patients receiving therapeutic antimicrobial agents sent samples for pathogenic detection. Antimicrohial usage rate in teaching hospitals was lower than non-teaching hospi- tals（X2 = 100.53, P = 0. 00）, antimicrobial usage rate had a ＂step-by-step＂ rise among hospitals with ≥900,600- 899,300 599, 〈300 beds（X^2 = 571.90, P = 0. 00 ; X^2 = 579.38, P = 0. 00 ; X^2 = 36. 11, P = 0. 00）. Departments with high use of antimierobial agents were pediatrics（85.50 %）, general intensive care unit（81.95 %） and respiratory dis- eases departrnent（76. 99%）. Conclusion Inpatients in 740 hospitals had high usage rate of antimicrobial agents, prophylactic and combined use is more, sample for pathogen detection was less, it is necessary to strengthen the management of antimicrobial use.