基层医院临床抗菌药物管理对比研究

Control study on the management of clinical antimicrobial agents application in basic-level hospital

目的调查某院开展抗菌药物临床合理应用管理工作的效果。方法选取2006年9月全部住院病例(开展抗菌药物临床合理应用管理后)作实验组,2005年9月全部住院病例(开展抗菌药物临床合理应用管理前)作对照组,对两组病例抗菌药物应用及住院费用情况进行对照研究。结果实验组989例病例中有643例使用抗菌药物,使用率为65.02%;对照组760例病例中有595例使用抗菌药物,使用率为78.29%;两组比较,差异有显著性(χ2=36.62,P<0.001)。实验组根据药敏结果用抗菌药物71例,占使用抗菌药物病例的11.04%;对照组13例,占2.18%;两组之差异有显著性(χ2=38.33,P<0.001)。实验组合理用药率为47.65%,显著高于对照组的37.77%(χ2=27.87,P<0.001)。实验组平均住院费为(2888.00±958.01)元,显著低于对照组的(3328.00±1 156.12)元(t=8.70,P<0.001);实验组平均抗菌药物费为(247.80±165.35)元,显著低于对照组的(513.50±251.42)元(t=26.36,P<0.001)。结论基层医院开展抗菌药物临床合理应用管理具有可行性和有效性,可明显提高抗菌药物应用的合理性,降低患者的医疗费用。

Objective To evaluate the effect of management of clinical antimicrobial agents rational application in a hospital. Methods All hospitalized patients in September 2006 （After carrying on the management of clinical antimicrobial agents rational application ） were as experimental group, all hospitalized patients in September 2005 （Before carrying on the management of clinical antimicrobial agents rational application ） were as control group, antimicrobi- al application and hospitalization expenses were studied. Results Six hundred and forty-three of 989 patients in experimental group used antimicrobial agents, the usage rate was 65. 02%; five hundred and ninety-five of 760 patients in control group used antirnicrobial agents, the usage rate was 78. 29%; there was significant difference between two groups （X^2 = 36. 62, P〈0. 001）. 71 （11.04%） and 13（2. 18%） patients＇ antimicrobial agents application in experimental and control group respectively were based on antimicrobial susceptibility test results; there was significant difference between two groups （X^2 = 38. 33, P〈0. 001 ）. The rational antimicrobial application rate in experimental group was 47. 65%, which was significantly higher than 37. 77% （X^2 = 27. 87, P〈0. 001 ） of control group. The average hospitalization expenses were （2 888. 00±958. 01 ） yuan in experimental group, which was significantly lower than（3 328. 00 ± 1 156. 12） yuan in control group （t = 8. 70, P〈0. 001） ; the average antimicrobial expenses were （247. 80 ± 165. 35） ）man, which was significant lower than（513. 50 ± 251.42） yuan in control group （t = 26. 36, P〈0. 001 ）. Conclusion The management of clinical antimicrobial agents rational application in basic-level hospital is practical and effective, which can improve the rational use of drugs and reduce patients＇ medical expenses.