抗菌药物应用管理成效分析

A cost-effectiveness analysis on the management of antimicrobial agents application

目的通过综合干预促进抗菌药物合理应用。方法成立医院抗菌药物管理委员会,规范用药原则,进行药学知识培训;加强微生物实验室建设等。回顾分析2004—2006年全部出院病例资料,评价上述管理措施的成效。结果抗菌药物使用率由2004年的70.18%下降到2006年的64.12%;治疗性用药率由2004年的40.10%上升到2006年的68.58%,预防性用药率由2004年的56.61%下降到2006年的31.09%,无指征用药率由2004年的3.29%下降到2006年的0.33%,单一用药率由2004年的68.76%上升到2006年的77.49%;病原学送检率由2004年的11.31%上升到2006年的50.60%。采取综合干预后,治疗性抗菌药物使用率、单一用药率及病原学送检率明显提高(均P<0.01),抗菌药物使用率、无指征用药率明显下降(均P<0.01)。结论通过药事委员会及相关部门的综合干预,可达到逐步规范临床抗菌药物合理使用的目的。

Objective To enhance the rational usage of antimicrobial agents by comprehensive interventional measures. Methods Several measures have been adopted in a hospital： to establish the antimicrobial administrative committee, improve antimicrobial usage criteria, provide training about knowledge of medicine, strengthen quality control and construct microbiological laboratory. Medical records from 2004 to 2006 were reviewed to analyze the achievement of above measures. Results The usage rate of antimicrobial decreased from 70. 18% in 2004 to 64. 12% in 2006% the therapeutic usage rate increased from 40. 10% in 2004 to 68. 58% in 2006% the preventive usage rate decreased from 56. 61% in 2004 to 31.09% in 2006,the non-indication usage rate decreased from 3. 29% in 2004 to 0. 33% in 2006,the single usage rate increased from 68. 76% in 2004 to 77. 49% in 2006, pathogenic detection rate of samples increased from 11.31% in 2004 to 50. 60% in 2006. After comprehensive intervention measures were taken, the therapeutic usage rate, the single usage rate and pathogenic detection rate of samples all increased obviously （all P〈0. 01）, both the usage rate and non-indication usage rate of antimicrobial agents decreased obviously （both P〈0. 01）. Conclusion The goal of gradually standardizing rational usage of antimicrobial agents can be achieved by participation of the administrative committee and other departments.