青浦区三家二级医院抗菌药物临床应用情况评价指标的建立与实践

Construction and practice of evaluation indicator of antimicrobial drug use on qingpu district of grade-two hospital

目的建立合适的抗菌药物(AMD)评价指标,快速、可靠地评价青浦区二级医院内AMD使用的主要问题。方法依据16项国际抗菌药物使用调研指标,以及联合用药调研指标,采用回顾性数据收集和分析方法对该地区三家二级医院的住院患者进行抽样调研。结果医院基本药物目录中有62种AMD,但缺乏成文的药物治疗指南性文件,住院处方中有≥应用1种AMD的住院患者数占住院患者总数的69.59%;处方平均2.49种AMD;每位患者的使用AMD平均费用是879.74元;AMD治疗患者非预防Ⅰ、Ⅱ类切口感染的平均天数是6.33d;77.39%手术患者接受AMD预防感染,平均次数为14.27次;26.08%的肺炎病例按照指导原则治疗;以通用名开AMD处方的百分率为89.91%;仅有17.38%的AMD治疗患者进行了病原体药敏试验。结论医院决策层及药事管理委员会对AMD监管力度仍嫌不足,处方者对AMD的规范性使用意识薄弱,药师仍需发挥更大的合理用药促进作用。

Objective To establish a suitable evaluating indicator of antibacterial drug（AMD）,fast and reliable assessment described the hospital management ofuse of AMD status in qingpu district of grade-two hospital.Methods Based on the 16 international anti-bacterial drug use survey indicators,and indicators of combination therapy study,using retrospective data collection and analysis methods of the author of three area hospitals inpatients two sample survey.Results Hospital essential drug list had 62 kinds of AMD,but the lack of written guidance document for drug treatment,hospital prescriptions had ≥1 kind of AMD patients admitted to hospitals accounted for 69.59%;The number of hospitalized patients;prescribed an average of 2.49 kinds of AMD;Each the use of AMD patients with the average cost was 879.74yuan;AMD patients treated with the non-prevention of I,II class wound infection,the average number of days was 6.33d;77.39% operative patients receiving AMD prevention of infection,the average number of 14.27 times;26.08% of pneumonia cases in accordance with the guidance the principle of treatment;To open AMD prescription generic percentage 89.91%;Only 17.38% of AMD patients treated with the drug sensitivity test carried out pathogens.Conclusion Hospital drug and therapeutics committee decision-making and supervision of the AMD is still not enough,prescriptions are for the use of AMD＇s normative sense of weak,pharmacists still need to play a greater role in promoting the rational use of drugs.