皮肤病医院门诊抗菌药物应用情况调查分析

Utilization of Antibacterials in Outpatients of Our Dermatological Hospital

目的:了解皮肤病医院门诊抗菌药物应用情况,评价门诊患者应用抗菌药物的合理性,提高临床抗菌药物合理应用水平。方法:采用回顾性调查方法,抽取皮肤病医院2007年1月～2009年12月门诊处方共计197368张;结合中心实验室病原学检查、药敏培养情况及药库抗菌药物出库统计,对抗菌药物使用基本情况以及不合理用药处方进行分析。结果:在所调查的处方中,含抗菌药物处方总计48850张,占24.75%,在48850含张抗菌药物处方中,24127例经病原检查确诊为感染性疾病或与感染相关的疾病,占49.38%,2355例进行药敏培养,占4.82%,不合理处方总计3427张,占7.01%。结论:医院抗菌药物临床应用总体良好,但也存在不合理应用情况,表现为在应用抗菌药物的患者中,只有不到半数患者经病原检查确诊为感染性疾病或与感染相关的疾病,药敏培养率低、选药不当、用法用量不当及不合理联用。主要原因是技术管理部门管理不到位,临床医生对病原检查和药敏培养重视不够,对药学知识缺乏足够了解,药学人员对不合理处方判断能力有限所致。

OBJECTIVE： To probe into the status quo and rationality of the utilization of antibacterial in our dermatological hospital so as to improve clinical rational drug use level. METHODS： A total of 197 368 prescriptions prescribed between Jan. 2007 to Dec. 2009 in dermatological hospital were reviewed retrospectively with regard to the utilization of antibacterials and the irrational prescriptions based on the etiological inspection and drug susceptibility cultures and the out - stockroom statistics of drugs. RESULTS： Of all the prescriptions reviewed,antibacterials were prescribed in 48 850 （24. 75% ）,of which,24 127 cases （49. 38% ） were confirmed as having infectious diseases or infection - related diseases pathogenically,2 355 cases （4. 82% ） received drug - susceptibility culture,and 3 427 （7. 01% ） were irrational prescriptions. CONCLUSION： The utilization of antibacterials in our hospital was satisfactory on the whole yet which is far from perfect in that there were only less than half of the antibiotic receivers were confirmed as having infectious diseases or infection-related diseases,the rate of drug susceptibility culture was low,it is improper in drug choice,dosage and administration and drug combination. These problems were mainly attributed to technical management departments’poor management,clinicians’lack of attention to pathogenic test and the susceptibility-culture and their lack of pharmaceutical knowledge and pharmacists’poor judgment on the irrational prescriptions.