北京市某二级医院住院患者抗菌药物使用情况调查分析

目的:分析我院各科住院患者抗菌药物使用情况,为规范临床抗菌药物合理使用及有效开展药学服务提供可靠依据。方法:选择2013年1—6月全部出院患者中使用抗菌药物病历426份,从抗菌药物的使用比例、临床品种选择、联合用药、用药频度及药物利用指数等各项数据进行调查统计,结合同期住院病原菌分布,综合分析抗菌药使用情况。结果:住院抗菌药物总使用率为58.36%;以单一用药为主,占67.65%,联合用药主要集中在二联;DDDs排序前10位中以头孢菌素类为主,其限制使用品种应用频次最高;多数药物DUI值﹤1.0,基本合理;依据病原学结果临床选药主要为经验用药,针对性较差。结论:我院住院患者抗菌药物使用率符合卫生部要求,但对抗菌药物的适应症、使用原则、不良反应等方面掌握不全面,存在滥用现象,需加强培训、事前干预及用药督导,严控临床经验用药习惯。

Survey on Antibiotics Application on Inpatients in A Secondary Hospital in Beijing

Objective：To analyze the application condition of antibiotics among inpatients in different departments, and provide refer- ence for standardizing antibiotics usage in clinical practice in future pharmaceutical care. Methods：Four hundred and twenty six case re- ports of patients discharged from Jan. 2013 to Jun. 2013 in our hospital that were given antibiotics were analyzed, in terms of proportion of antibiotics application, clinical selection of antibiotics types, antibiotics combination, DDDS and DUI, as well as distribution of pathogens of the same hospitalization period, to comprehensively analyze the use of antibiotics agents. Results ：The proportion of antibiot- ics application was58.36% ; single usage of one kind of antibiotics was 67.65%. Combined application of antibiotics was mainly the us- age of two kinds of drugs. Top 10 DDDs were mainly drugs of cephalosporins, among which restricted antibiotics were the majority. Most DUI were less than 1.0, which were basically rational. The rule of selecting antibiotics was mainly based on experience, rarely in ac- cordance with pathologic examination results, so the diseases were poorly targeted. Conclusion：Antibiotics usage proportion in Guangwai hospital among inpatients meets the criteria of Ministry of Health. However, the indications, adverse reactions and principles of applying antibiotics are not fully grasped, and there is antibiotics abuse to some extent. Training and medication supervision need to be strength- ened, so as to strictly control the clinical application of antibiotics.