抗菌药物使用情况1846例临床分析

Clinical Analysis of Antibacterial Drug Used in 1846 Cases

目的调查医院临床抗菌药使用情况,针对发现的问题提出合理的解决方案,以提高临床合理用药水平.方法抽取吉林省前卫医院有住院部的18个临床科室2012年3～5月每月1,5,9,13,17,21,25,29日共8 d的出院病历共1846份,对所有病历的抗菌药物使用情况进行统计分析.结果经统计分析,医院有63.4%的住院患者使用过抗菌药,使用的抗菌药物种类共42种,在使用抗菌药的患者中有84.7%的患者使用过2种及以上抗菌药物,其中联合用药达6种以上的患者74名,在使用抗菌药的患者中有56.2%的患者进行了药敏实验,但无一例患者进行血药浓度监测.在所有18个临床科室中,手术科室抗菌药的使用率和联合用药率明显高于非手术科室.结论虽然经过努力,抗菌药物的使用率已接近国家要求,但在使用抗菌药物的患者中缺少必要的药敏实验,存在凭经验开方的现象,在高危抗菌药物联合应用中缺乏血药浓度监测.针对以上问题,应从医院和患者两方面入手方能得到较好的解决.

Objective This study is to investigate the clinical application of antibacterial drug in our hospital in order to provide a rational solution for the use of those agents and to improve the level of reasonable antibacterial application.Method 1846 medical records from in-patients who had been hospitalized in 18 sections and discharged on 1st,5th,9th,13th,17th,21st,25th and 29th of each month,8 days in total,during March 2012 to May 2012 were collected.A statistical analysis on the antibacterial drug application written in all the medical records was performed.Results 42 kinds of antibacterial agents were used with the rate of 63.4% of in-patients,there were 84.7% of the total patients who were given more than two types of antibacterial drugs,74 patients were administered more than 6 kinds of antibacterial agents in the combination,and 56.2% of the patients were asked to receive the drug sensitivity tests,but no one case was asked to monitor his blood drug concentration.Among 18 clinical sections,the rate of the antibacterial drug use and combination in surgical departments was significantly higher than that in non-surgical departments.Conclusion Through the continuous effort in the hospital,the usage rate of antibacterial drug in our hospital has progressively closed to the relevant documentation requirement issued by our country.However,there has been a lack of the implementation of necessary drug sensitivity tests and blood drug concentration monitoring in high-risk patients who are administer antibacterial agent in combination,indicating that the doctors may prescribe drugs only based on their experiences,and blood concentration monitoring was lacking in the link application among antibacterial agents.Aiming at the problems described above,they could be solved by starting with the two aspects of hospital and patients.