北京市70家医院重症监护病房碳青霉烯类抗菌药物及替加环素应用的横断面研究

目的：调查重症监护病房碳青霉烯类抗菌药物和替加环素的管理及使用现状。方法：采用横断面研究方法，选取北京市70家医院，分别从每家医院抽取5份病历，根据相关文件设计检查评分表对病历进行评分以评估合理性，并探索病历合理性的影响因素。结果：70家医院实际抽查病历329份，其中二级医院83份，三级医院246份，病历总体评分均分为（13.3±1.9）分（15分）。使用多重线性回归进行多因素分析结果显示，二级医院得分低于三级医院（P<0.001）；中医医院低于综合医院（P=0.007）和专科医院（P=0.036），专科医院与综合医院无统计学差异（P=0.771）；美罗培南病历的得分低于亚胺培南（P=0.003）。结论：各级医院，尤其是二级医院和中医医院仍需通过进一步加强医务人员对碳青霉烯类抗菌药物和替加环素的管理和使用培训，促进抗菌药物合理使用。

A cross-sectional study of carbapenems and tegacycline in the intensive care unit of 70 hospitals in Beijing

OBJECTIVE To investigate the management and use of carbapenem antibiotics and tigecycline in intensive care units.METHODS A cross-sectional study was conducted in 70 hospitals in Beijing. Five medical records were collected from each hospital. According to the relevant document design check score table, the medical records were scored to evaluate the rationality, and explore the factors affecting the rationality of the medical records.RESULTS There were 329 medical records in 70 hospitals, of which 83 were secondary hospitals and 246 were tertiary hospitals. The overall score of medical records was (13.3±1.9)points (15 points).The results of multivariate analysis using multiple linear regression showed that secondary hospitals had lower scores than tertiary hospitals (P<0.001); TCM hospitals had lower scores than general hospitals (P=0.007) and specialty hospitals (P=0.036), and there was no statistically significant difference between specialty hospitals and general hospitals (P=0.771); Meropenem medical records had lower scores than imipenem (P=0.003).CONCLUSION The hospitals, especially secondary hospitals and traditional chinese medicine hospitals, still need to further strengthen the training and antimicrobial management of carbapenem antibiotics and tigecycline by medical staff to promote the rational use of antibacterial drugs.