住院患者抗菌药物临床应用调查分析

Antibiotics Clinical Usage Analysis on Inpatients

目的了解桂林医学院附属医院抗菌药物的使用现状,从而提高临床使用抗菌药物的合理性。方法对2010年11月8日0时～24时所有住院患者进行抗菌药物使用调查,由医院感染管理科、药剂科、护理部工作人员及临床科室医院感染监控医师组成10个调查小组,采用床旁调查、医护人员询问和病历调查相结合的调查方式,填写个案调查表。结果在所调查的1066例住院患者中,抗菌药物使用率为36.87%,抗菌药物联合用药率为18.32%,联合用药中两联用药占18.07%,三联用药占0.25%,无四联用药。抗菌药物预防性用药占30.53%,存在外科Ⅰ类切口手术围术期预防用药过度及内科疾病抗菌药物预防性应用指征不明确等问题。住院患者病原体培养及药敏试验的送检率为34.8%。结论治疗性用药病原学送检率较低,抗菌药物选用以经验用药为主,缺乏科学依据,需要加强抗菌药物合理应用的管理,提高抗菌药物应用水平。

Objective To investigate the usage of antibiotics,and to improve the rationality of clinical usage. Methods An- tibiotics usage survey was made on November 8,2010 within the inpatients. Ten survey teems were composed by the staff of de- partment of nosocomial infection management, phamacy department, nursing department and clinical physicians, using a combina- tion of bedside investigations, inquirying and medical records surveying. Investigation forms were completed. Results Among 1066 inpatients, the rate of antibiotic usage was 36.87%. The combined antibiotic rate was 18.32%, 18.07% were given double drug ,0.25% were given triple and none were given quadruple therapy. The rate of prophylactic antibiotic usage was 30.53%. Ex- cessive antibiotics usage existed in perioperative period of type I incision surgery and the indication for prophylactic antibiotics us- age in physician was not clear. Rate of etiological examination for infectious patients was 34.8%. Conclusion The rate of etiological examination for therapeutic medication was low. Most antibiotics were used according to clinical experience, lacking scientific basis. Management should be strengthened for rational use of antibiotics to improve the level of using antibiotics.