269例细菌性感染疾病抗菌药物临床分析

Antimicrobial Agents Use in 269 Patients with Bacterial Infective Diseases

目的了解医院治疗性抗菌药物应用及病原学送检现状。方法对医院2007-2009年收治的细菌感染性疾病患者病历资料进行回顾性与前瞻性调查,并采用Excel软件进行数据处理。结果 269例细菌性感染疾病患者以切口感染为主(34.94%),其次为上呼吸道感染(23.42%),病原学送检率为24.16%;入院初始抗菌药物应用以经验治疗为主,尤以第三、四代头孢菌素类比率最高(24.35%),青霉素类位居第2(19.89%);单一用药率为20.82%,二联用药占64.31%,三联用药占14.87%,未发现>三联用药现象;给药剂量、次数,联合用药种类搭配不恰当,更换药间隔时间过短是主要不合理用药现象。结论医院最常见的细菌感染性疾病是切口感染,抗菌药物应用总体较为合理,但病原学送检率低,部分临床医师用药不规范,必须加强培训。

OBJECTIVE To investigate the application of antimicrobial agents in hospital and the etiology detection status.METHODS The inpatients with bacterial infectives diseases in 2007-2009 years were reviewed with the prospective and retrospective study,and Excel software was used for data processing.RESULTS The majority was incision infection（34.94%）,followed by upper respiratory tract infection（23.42%） from 269 cases of bacterial infections inpatients,the rate of etiology detection was 24.16%.The initial use of antimicrobial agents was empirically,especially the third and fourth generation cephalosporins were the highest（24.35%） and penicillins were the second（19.89%）.The single-drug rate was 20.82%,the double-drug rate accounted for 64.31%,the triple-drug use was 14.87% and without more than triple-drug use.The major phenomena of irrational drug use were the drug dose,frequency,inappropriate combination therapy and the over short interval of drug replacement.CONCLUSIONS The most common bacterial infection in hospital is incision infection,the antimicrobial drug use is reasonable in general,but the rate of the etiology detection is low.The prescription of some clinicians is not standard,and the training needs to be strengthened.