住院患者抗菌药物使用合理性分析

The retrospection appraisal of the antibiotics use of inpatient

目的探讨不合理使用抗菌药物原因,以期指导合理使用抗菌药物。方法分析医院320份住院病历抗菌药物合理性分析报告。结果在320份使用抗菌药物病历中,不合理使用病历136份,不合理率达42.50%。外科系统160份病历中,不合理使用93份,不合理率为58.12%;内科系统160份中,不合理使用43份,不合理率为26.88%。结论外科系统在围术期预防抗菌药物时,用药时机、预防时限、药物选择、Ⅰ级切口预防使用抗菌药物率高,存在诸多不规范问题;内科系统存在抗菌药物使用指征掌握不严、缺乏临床循证证据支持等问题;对及时取标本送病原学检查重视不够,经验性抗感染占较大比例,且以换药频繁为主要特征等不合理现象,需进一步规范,持续改进。

Objective To analysis the because of irrational use of antibiotics in our hospital during 2009 to 2010,in order to guide the rational use of antibiotics.Methods Analysed of patient medical records of 320 hospital antimicrobial rational analysis.Results In implementation realization the medical department＇s document of antibiotics clinical practice guiding principle,there still were many use antibiotics unreasonable phenomenon.Used antibiotics unreasonable hospital medical records 136 altogether（42.50%）,unreasonable records 93 cases in 160 surgical department system medical records,the rats was 58.12%,unreasonable records 43 cases in 160 internal medicine department system medical records,the rate was 26.88%.Conclusion Surgical system in the prevention of perioperative antibiotics,the medication time to prevent time,drug selection,Ⅰ grade cut high to prevent the use of antimicrobial drugs,there are many non-Lstandard problems;Medical system has strict control antimicrobial drug use indications,the lack of clinical evidence-Lbased evidence to support such issues;Etiology of time the specimens sent to check the inadequate attention,a higher proportion of empirical anti-Linfective,and the dressing frequently as the main characteristics of anomaly should be further standardized,continuous improvement.