药师对抗菌药物合理使用的干预效果分析

目的 对药师干预前后的抗菌药物使用情况进行分析,评价药师对抗菌药物合理使用的干预效果.方法 选取江苏省常熟市中医院（以下简称“我院”）2010年1～12月有完整病例的512例门诊和住院患者作为未干预组（未行药师干预）,另对照选取我院2011年1～12月的509例门诊和住院患者作为干预组（实施药师干预）.对比两组患者抗菌药物使用率、抗菌药物使用合理性,同时对照两组住院患者药敏实验送检率、抗菌药物占医疗费用比例和住院时间.结果 ①未干预组和干预组的抗菌药物使用率分别为71.1％和58.2％,差异有统计学意义（P＜0.05）;与未干预组比较,干预组抗菌药物使用基本合理比例差异无统计学意义（P＞0.05）,但合理比例明显增加（P＜0.05）,不合理比例明显减少（P＜0.05）.②两组抗菌药物二联使用情况差异无统计学意义（P＞0.05）;与未干预组比较,干预组单一用药比例显著升高,三联及以上用药比例明显下降,差异均有统计学意义（P＜0.05）;干预组较未干预组注射剂使用率显著降低、口服制剂使用率显著升高（P＜0.05）.③与未干预组比较,干预组住院患者药敏试验送检率明显提高,抗菌药物占医疗费用比例明显下降,住院时间明显缩短,差异均有统计学意义（P＜0.05）.结论 采取药师干预措施能有效促进临床更合理地使用抗菌药物资源,值得临床推广实施并进一步探索更为有效的措施.

Effect analysis of pharmacists intervention on the rational use of antimicrobial drugs

Objective To observe and analyze the usage of antimicrobial drugs before and after the intervention of the pharmacist,and to evaluate the effect of the intervention on the rational use of antimicrobial drugs.Methods 512 cases of outpatient and inpatient in Chinese Medicine Hospital of Changshu City （“our hospital” for short） from January to December 2010 were selected as non-intervention group （no pharmacists intervention）,509 cases of outpatient and inpatient in our hospital from January to December 2011 were chosen as intervention group （with pharmacists intervention）.Antimicrobial usage ratio,antimicrobial drug usage rationality,submission rate of susceptibility test,medical expense ratio of antimicrobial drug,hospital stays were observed and compared.Results ①Antimicrobial usage ratio of non-intervention group and intervention group were 71.1％ and 58.2％,the difference was statistically significant （P ＜0.05）.Basic reasonable proportion in the two groups was found had no statistically significant difference （P ＞ 0.05）;reasonable proportion in intervention group was higher than that of non-intervention group （P ＜ 0.05）,unreasonable proportion intervention group was lower than that of non-intervention group （P ＜ 0.05）.②The duplex use of antimicrobial agents in the two groups was found had no statistically significant difference （P ＞ 0.05）.Single usage ratio in intervention group was higher than that in non-intervention group,trigeminy and more than trigeminy usage ratio in intervention group was lower than that in non-intervention group,the differences were statistically significant （P ＜ 0.05）.Injection usage ratio in intervention group was lower than that in non-intervention group,oral usage of ratio in intervention group was higher than that in non-intervention group,the differences were statistically significant （P ＜ 0.05）.③Susceptibility experiment inspection rate of intervention group was higher than that of non-intervention group,antibacterial drug cost ratio and hospital stays of intervention group were lower than that of non-intervention group,the differences were statistically significant （P ＜ 0.05）.Conclusion Pharmacists intervention can effectively promote the usage of antimicrobial agents,it is worthy of clinical implementation.