四川省医疗机构“特殊使用”类抗菌药物利用研究

目的:分析四川省医疗机构"特殊使用"类抗菌药物的应用情况,为减少抗菌药物引发不良反应、避免细菌过快产生耐药性提供参考。方法:采用药物利用研究中的限定日剂量、用药频度(DDDs)等指标,对我省2005年1月～2008年6月"特殊使用"类抗菌药物的应用情况进行分析。结果与结论:不同"特殊使用"类抗菌药物品种,其DDDs、采购金额排序及所占比例等指标变化各不相同;部分抗菌药物购入金额及其DDDs排序比介于0.33～5.00之间;72.22%的"特殊使用"类抗菌药物在各级医疗机构均有应用,应从严引进,并严格按要求应用;部分"特殊使用"类抗菌药物耐药率高达100%,应按有关规定暂停使用,全部纳入细菌耐药监测范围,建立临床应用预警机制;针对一定程度的滥用问题,应在基层医疗机构采取严格的限制措施。

Investigation on Utilization of Antibiotics for Special Use in Medical Institutions of Sichuan Province

OBJECTIVE ： To analyze utilization of antibiotics for special use in medical institution in order to provide reference of reducing incidence of ADR and avoiding rapid occurrence of bacterium. METHODS： The utilization of antibiotics for special use in our province from Jan. 2005 to Jun. 2008 was analyzed with DDD and DDDs as index. RESULTS＆CONCLUSION： The changes of DDDs, cost order and proportion of antibiotics for special use were different from each other. The ratio of order of cost to order of DDDs of antibiotics for special use was between 0.33-5.00 and 72.22% of antibiotics for special use were widely used in different grades of medical institutions. Therefore, it is necessary to strictly control the introduction and utilization which meet requirement. Drug resistance rate of some antimicrobials for special use is up to 100%. So the relevant measure should be taken such as withdrawal of antibotics, monitor of drug resistance and establishment of warning system. Considering a certain degree of abuse, strict measure should be adopted in the primary medical institutions.