头孢菌素类抗生素在不同级别医院应用情况分析

目的了解上海市某区头孢菌素类抗生素应用情况，为临床合理选用头孢菌素类抗生素提供参考和用药信息。方法利用Excel对15家医院2012年头孢菌素类抗生素集中购药金额、用药频度（DDDs）、限定日费用（DDC）等进行统计，对不同级别医院用具体品种进行分析。结果2012年购药金额位居第1是二级医院，占总购药金额的37．85％；头孢替安、头孢美唑和头孢曲松注射剂分别占据一、二、三级医院购药金额排序第1位，一级医院口服剂型购药金额高于注射剂型为61．37％；二级、三级医院注射剂型高于口服剂型，分别为68．41％和71．93％。DDDs位居首位是一级医院，其中头孢呋辛酯DDDs高达53．80，头孢呋辛钠为6．74，占据不同级别医院口服剂和注射剂的DDDs排序第1位。DDC最高是三级医院29．53元；一、二、三级医院DDC最高／最低分别是头孢替安120．84元／头孢曲松2．70元；头孢美唑204．55元／头孢拉定3．32元和头孢匹胺224．35元／头孢拉定3．52元均为注射剂。结论一级医院购药金额最少，DDDs最高；DDC最低。应继续加强头孢菌素类抗生素的临床应用管理，以确保临床用药的有效、安全、和经济。

Analysis of Applications of Cephalosporins in Hospitals of Different Levels

Objective Understanding the application status of the cephalosporin in specified district, Shanghai, and to provide reference for rational clinical use of cephalosporin antibiotics. Methods Collecting the data of centralized purchase cost, DDDs, defined daily cost （DDC） of cephalosporins for 15 hospitals in 2012, analyzed specific varieties for hospitals of different levels. Results The second level hospital ranked No. 1 in terms of purchase cost in 2012, 37.85% of the total purchase cost. Cefotiam ranked the top of purchase cost list for first level hospital. So is the cefmetazole for second level hospital and ceftriaxone injections for third level hospitals. In first level hospital, the medicine in oral dosage form, which is account for 61.37% of the total purchase cost, is higher than the injectable medicine. But in second and third level hospitals the injectable medicine, which account for 68.41% and 71.93% respectively, are higher than the oral dosage. As on DDDs, The first level hospital rank the first, with cefuroxime axetil, which reach 53.80, ranked No. 1 in DDDS of oral agents and cefuroxime sodium which reach 6.74, top the DDDs list of injection form. As on DDC, the third level hospitals is the highest, peaked at 29.53 yuan. In the first level hospital, the medicine with the highest DDC is Cefotiam, at 120.84 yuan, the lowest is ceftriaxone, at 2.70 yuan. In second level hospital, the highest is cefmetazole at 204.55 yuan, the lowest is cefradine at 3.32 yuan. In third level hospital, the highest is cefpiramide at 224.35 yuan, the lowest is cefradine at 3.52 yuan. All the medicine above are in injection form. Conclusion With the lowest purchase cost and DDC, as well as highest DDDs in first level hospital, we should continue to strengthen the management of the clinical application of cephalosporin antibiotics, in order to ensure the clinical use of drugs are effective, safe, and economical.