医院老年住院患者抗菌药物应用的对比分析

目的了解老年住院患者抗菌药物的使用现状和存在问题,为临床安全、合理、有效地使用抗菌药物提供参考。方法随机抽取北京友谊医院、北京天坛医院、北京宣武医院、北京同仁医院2000年和2004年老年住院病历254例、274例,对抗菌药物应用情况进行回顾性调查。结果4所医院2000年和2004年老年住院患者抗菌药物的使用率分别为73.2%和74.1%,合理使用率分别为78.0%和68.0%;其中,单纯预防性用药者占26.3%和35.5%、单纯治疗性用药者占43.5%和36.9%、预防合并治疗性用药者占29.0%和27.1%、用药指征不明确者占1.1%和0.5%;经验性用药和参考病原学检查用药分别占95.2%和92.6%、4.8%和7.4%。结论北京4所医院老年住院患者两年的抗菌药物使用率差异无统计学意义,但2004年比2000年抗菌药物合理使用率下降,提示临床工作中必须重视老年患者不合理应用抗菌药物现象。

Antibiotic Application in Elderly Inpatients:A Comparative Analysis

OBJECTIVE To estimate the status quo and existing problem of antibiotic use in elderly in patients of four hospitals in Beijing and provide reference for safe,rational and effective clinic antibiotic use. METHODS The data of elderly patients in 2000(n=254) and in 2004(n=274) were collected randomly and analyzed retrospectively. RESULTS Of the selected patients in 2000 vs 2004,73.2% vs 74.1% were receiving antibiotics.The rate of rational antibiotic use was 78.0% vs 68.0%.The purpose of antibiotic use was for simple prophylaxis in 26.3% vs 35.5%,for simple therapy in 43.5% vs 36.9%,for both therapy and prophylaxis was 29.0% vs 27.1%,for ambiguous aim was 1.1% vs 0.5%.The purpose of antibiotic use was as an empiric decision in 95.2% vs 92.6%,respectively. CONCLUSIONS There is unreasonable antibiotic usage in elderly patients of the four hospitals,and clinician should pay attention to it.