970例住院患者抗菌药物使用情况调查

目的　了解某院抗菌药物使用现状和存在的问题 ,指导临床医师合理应用抗菌药物。方法　对某院2 0 0 2年 12月的 970份出院病历 (不包括结核病患者 )进行回顾性调查 ,记录每例病例抗菌药物使用情况 ,对抗菌药物使用率、用药种类、用药时间、药敏情况等进行分析。结果　 970例出院患者中 ,有 70 9例使用了抗菌药物 ,抗菌药物使用率为 73.0 9% ,其中预防用药占 4 1.6 1% ;只用 1种抗菌药物的有 36 0人 ,占 5 0 .78% ,使用 4种以上抗菌药物的有 72人 ,占 10 .16 % ;使用较多的抗菌药物依次为青霉素类 (包括抑酶联合制剂 )、喹诺酮类、抗厌氧菌药物和三代头孢菌素 ;5 8.5 4 %的患者用药时间 <7d ,15 .37%的患者用药 >14d ;进行药敏试验的患者仅占全部用药人数的 5 .36 %。结论　部分住院患者抗菌药物使用中存在病原送检率低 ,抗菌药物应用起点较高、换药频繁、用药时间较长等不合理现象 ,抗菌药物的使用管理需要加强。

Investigation of antimicrobial usage in 970 inpatients

Objective To investigate the problems in the usage of antimicrobial agents in a hospital and provide guidance for the rational use of antimicrobial agents in clinic. Methods Antimicrobial usage in patients (patients with tuberculosis were excluded) who were discharged from hospital in December, 2002 were analysed retrospectively by medical record reviewing. Results Seven hundred and nine of 970 discharged patients ( 73.09%) used antimicrobial agents, 41.61% were for preventive administration; 360 ( 50.78%) patients used only 1 kind of antimicrobial agent, 72 patients ( 10.16%) used at least 4 kinds of antimicrobial agents. The commonly used antimicrobial agents were penicillins, quinolones, anti-anaerobic agents and the third generation cephalosporins; 58.54% of patients used antimicrobial agents for less than 7 days, and 15.37% for more than 14 days. Samples from only 5.36% of patients receiving antimicrobial agents were performed antimicrobial susceptibility test. Conclusion Some patients used antimicrobial agents irrationally, detection rate of samples for antimicrobial susceptibility test was low, the usage of antimicrobial agents should be paid attention.