住院患者抗菌药物临床应用横断面调查

Clinical Application of Antimicrobial Agents for Inpatients: A Cross - sectional Study

目的:了解医院抗菌药物应用情况及合理性。方法:采用横断面调查方法,调查1日的全院住院患者抗菌药物的使用情况。结果:1503例住院患者中,抗菌药物横断面使用率为51.1%,联合用药比例为45.7%,术科系抗菌药物使用率(68.5%)明显高于内科系(39.2%);联合用药率最高的是呼吸科、综合ICU和产科,分别为89.6%、85.7%和72.7%;DDDs前的10位抗菌药物中,头孢菌素类5个、氟喹诺酮类4个、氨基糖苷类1个,限制使用类别9个,特殊使用类别1个,大部分头孢菌素类抗菌药物临床所用剂量高于限定日剂量;病原学送检率为55.3%。结论:全院尤其是术科系预防用药和联合用药构成比偏高,限制使用和特殊使用类别药物使用率过高,部分头孢菌素类用药剂量过大,需要进一步加强抗菌药物合理应用的管理。

OBJECTIVE： To investigate the rationality of the clinical application of antimicrobial agents in a hospital. METHODS： A cross - sectional study was carried out on the utilization of antimicrobial agents for all the inpatients within a day in our hospital. RESULTS： Among a total of 1503 inpatients investigated,the rate of cross - sectional use of antibiotics was 51. 1% ,with a drug combination rate of 45. 7% . The antibiotic use rate in surgical department was significantly higher than in department of internal medicine （68. 5% vs. 39. 2% ）. The department of respiratory disease had the highest drug combination rate of 89. 6% ,followed by comprehensive ICU （85. 7% ） and the maternity department （72. 7% ）. Of the top ten antibiotics on the list of DDDs,5 were cephalosporins,4 quinolones,1 aminoglycosides,1 was restrictive use category,and 1 special use category. The dosages of most cephalosporins applied were higher than DDD （defined daily dosage）. The total rate of pathogens sent for etiological examination in the hospital was 55. 3% . CONCLUSIONS： The proportions of prophylactic medication and drug combination in the hospital especially in the surgical department are on the high side. The application rates of antibiotics for restrictive use or special use were also too high. The dosages of some cephalosporins were too high. Management on rational use of antimicrobial agents should be further strengthened.