干预前后我院抗菌药使用情况与细菌耐药分析

目的：分析干预前后我院抗菌药临床应用情况及临床分离菌对常用抗菌药的耐药情况。方法：利用信息检索系统,查询我院2012第一季度（干预前）、2013年第一季度（干预后）抗菌药消耗量,对抗菌药的用药频度（DDDs）进行排名及细菌对临床常见抗菌药耐药率进行分析。结果：干预前后排名前十的抗菌药相差较大,但仍都以头孢菌素类为主,DDDs整体下降明显。细菌的分离率和分布情况基本保持不变。肠杆菌科大肠埃希菌ESBLs产酶率降低了7.61%,肺炎克雷伯菌ESBLs产酶率降低了1.34%,对常用抗菌药的耐药率整体下降。相比革兰阳性葡萄球菌对常用抗菌药的耐药率降低。革兰阳性肠球菌对常用抗菌药的耐药率相差较大。结论：干预后我院抗菌药DDDs和细菌的耐药率整体下降,但并不是所有细菌的耐药率均下降,因此,临床治疗用抗菌药时应尽早做药敏试验,根据药敏试验结果选药。

Analysis of Antibiotics Use and Bacterial Resistant before and after Intervention in Our Hospital

Objective：To analyze the use status of antibiotics and the resistance of clinic isolate bacteria against the commonly used antibiotics before and after the intervention. Methods：Using the information retrieval systems, the consumption of antibiotics in the inpatients during the 1st quarter of 2012（before the intervention） and the same period of 2013（after the intervention） was compared. According to the defined daily dose （ DDDs） , the antibiotics were ranked, and the resistance rate against the commonly used antibiotics was analyzed. Results：Compared with the top ten before the intervention, the top ten after the intervention was changed significantly, however, cephalosporins was still the main species. After the intervention, the overall decline in DDDs was significant, the separation rate and distribution of bacteria remained stable. ESBLs enzyme production rate of Enterobacteriaceae Escherichia coli was reduced by 7. 61%, and that of Klebsiella pneumoniae was reduced by 1. 34%, and the resistance rate against the commonly used antibiotics was in an overall downward trend. The resistance rate of Gram-positive staphylococci against the commonly used antibiotics was decreased, while that of Gram-positive enterococci showed notable difference. Conclusion：The DDDs of antibiotics and bacterial resistance rate are in an overall downward trend in our hospital after the intervention;however, there is still exception. Therefore, the clinical antimicrobial susceptibility tests should be performed as soon as possible to help the choice of antibiotics.