综合性医院抗菌药物应用调查分析与管理对策

目的 了解我院抗菌药物的应用状况，指导临床合理使用抗菌药物。方法 对2001年9月份出院病历l517份的抗菌药物的使用情况编制调查表，进行统计分析。结果 我院抗菌药物总应用率为71．38％，预防性用药占66．14％，联合用药率为50．46％，以经验用药为主，抗菌药物应用频率最高的种类是头孢菌素类，其次为青霉素类和喹诺酮类，抗菌药物费用占总药费24．43％，新型、昂贵抗菌药物所占费用大，主要存在问题有外科系统预防性使用抗菌药物过宽，围手术期预防用药不规范，经验用药和选用高档抗菌药物较多，病原学送检率低。结论 我院抗菌药物应用率处于国内中位水平，不合理应用仍占相当比例，加强抗菌药物合理应用与规范化管理，提高医务人员合理用药整体水平是医院感染管理工作的重要内容之一。

Application of Antibiotics in General Hospital: A Survey Analysis and Administrative Countermeasures

OBJECTIVE To investigate the usage of antibiotics in our hospital for improving the management and proper clinical utilization.METHODS A total of 1 517 patients discharged from our hospital in Sept 2001 were surveyed, and a statistical analysis was conducted. RESULTS The rate of antibiotics usage was 71.38%, and the rate of preventive usage was 50.46%. Most antibiotics were used according to experience. Cephalosporins were the first, penicilins were the next and then quinolones in the antibiotics usage. And the cost of antibiotics was 24.43% in total drug expenses of the hospital. New kinds and expensive antibiotics were mainly the drugs in high expenditure. The major problems are excessive preventive usage in surgical system, substandard preventive usage in perioperative period, usage according to experience, excessive selection to expensive antibiotics, and low etiology examination.CONCLUSIONS The usage of antibiotics in our hospital was in mid level in Chinese hospitals. There were rather high proportion of substandard usage. The results showed that it is very important to strengthen the management of antibiotics usage in hospitals.