专项整治前后我院呼吸病区抗菌药物应用情况分析

目的：评价开展抗菌药物专项整治活动对我院呼吸病区抗菌药物合理应用的作用。方法：回顾性统计我院呼吸病区开展抗菌药物专项整治活动前（2010年8-12月,整治前）、后（2011年8-12月,整治后）出院患者的临床资料和抗菌药物应用情况。结果：我院抗菌药物应用率均值由整治前的96.93%下降至整治后的79.78%（P〈0.05）,抗菌药物费用占药品总费用的比例均值由整治前的43.81%下降至整治后的32.99%（P〈0.05）,抗菌药物使用强度（AUD）均值由整治前的67.72DDDs/100人/天降至整治后的51.10DDDs/100人/天（P〈0.05）。整治后抗菌药物总用药频度（DDDs）较整治前下降32.49%,注射剂类降低35.30%,口服剂类无明显变化;非限制使用类抗菌药物所占比例由46.43%降至39.67%,呈下降趋势,而限制使用类抗菌药物所占比例由53.57%上升至60.33%,呈上升趋势;痰培养阳性菌对常用抗菌药物的耐药率有所降低。单药应用率由整治前的24.43%上升至整治后的48.15%,二联用药率由整治前的73.76%下降至整治后的51.85%。结论：抗菌药物专项整治对我院呼吸病区合理应用抗菌药物有明显的促进作用,但抗菌药物使用率、AUD和限制使用类抗菌药物比例尚未达到理想要求,需进一步加强宣教和监管。

Analysis of the Application of Antibacterials in Respiratory Ward of Our Hospital before and after Special Rectification

OBJECTIVE： To evaluate the effects of antibacterial special rectification on rational use of antibacterial in our hospital. METHODS： Information of discharged patients and antibacterial use in respiratory ward of our hospital were analyzed retrospectively before （Aug.-Dec. 2010） and after （Aug.-Dec. 2011） rectification. RESULTS： The utilization rate of antibacterials decreased from 96.93% before rectification to 79.78% after rectification（P0.05）;the proportion of antibacterial cost in drug cost decreased from 43.81% before rectification to 32.99% after rectification（P0.05）; AUD decreased from 67.72 DDDs/100 persons/day before rectification to 51.10 DDDs/100 persons/day after rectification（P0.05）. DDDs of antibacterials decreased by 32.49% after rectification, that of injection by 35.30%, and that of oral preparation had no obvious change; the proportion of unrestricted antibacterial drugs decreased from 46.43% to 39.67%, showing a downward trend; the proportion of restricted antibacterial drugs increased from 53.57% to 60.33%, showing an increasing trend. Drug resistance rate of sputum-culture positive bacteria to common antibacterials reduced to some extent. The application rate of single drug increased from 24.43% before rectification to 48.15% afters rectification, and that of two-drugs rate decreased from 73.76% before rectification to 51.85% after rectification. CONCLUSION： Antibacterial drug special rectification promotes reasonable application of antibacterial drugs in our hospital obviously. But the usage of antibacterial drug, AUD and the proportion of restricted antibacterial drug have not yet reached the ideal requirements, which need to further strengthen education and supervision.