我院心胸外科抗菌药物临床应用差异化指标的研究与制定

目的 调查心胸外科住院患者抗菌药物临床应用情况，制定心胸外科抗菌药物临床应用规范和抗菌药物临床应用差异化指标，为临床医师合理用药提供依据。方法 回顾性随机调查我院2014年1-12月心胸外科300例住院患者病历，制定该院心胸外科常见疾病抗菌药物临床应用规范；分析、计算、统计抽样患者抗菌药物使用强度、使用率及Ⅰ类切口预防用抗菌药物使用率的实际值与理论值，确立差异化指标。结果 我院2014年心胸外科住院患者实际抗菌药物使用率、Ⅰ类切口预防用抗菌药物使用率和抗菌药物使用强度分别为72.7%、92.6%和61.2 DDDs/（100人·d），制定的差异化指标分别为69.3%、63.0%和49.3 DDDs/（100人·d）。结论 我院心胸外科住院患者抗菌药物临床应用存在无指征用药、用药品种和档次过高、给药疗程过长、联合用药或更换药物不合理等问题，需待加强管理，以促进抗菌药物临床合理应用。

Research and establishment of antibiotics differentiated indexes in clinical application of cardiothoracic surgery in our hospital

Objective To formulate the clinical application specification of antibiotics, make a deference index of antibacterial drugs in chest department according to the investigation about the antibiotics'' utility situation in chest department in 2014 and provide a theoretic foundation for the clinical doctor to promote the clinical rational drug use. Methods The antibiotics'' application information of 300 cases inpatients in the chest department of a hospital in 2014 were researched and analyzed through retrospection, regarding with the relevant regulations and related clinical practice guidelines, the clinical application specification of antibiotics was formulated and the analysis,calculation, statistics to the actual and theoretical value of the rate and intensity of antibiotics'' application, the application rate of the prophylactic antibiotics of type I incision on the inpatients in the chest department had been done. The differentiation index of them were establish. Results The rates of the actual antibiotics'' application and the prophylactic antibiotics of type I incision respectively were 72.7% and 92.6%, while the intensity of antibiotics'' application was 61.2 DDDs/(100 persons·d). The deference indexes of them were developed 69.3%, 63.0% and 49.3 DDDs/(100 persons·d). Conclusions There''re still much irrational places in the use of antibiotics in chest department of the hospital. It''s essential to strengthen supervision in order to promote the rational use of antibiotics in clinical practice.