住院患者抗菌药物使用调查分析及管理对策

Investigation of use of antibiotics in hospitalized patients and management strategies

目的了解住院患者抗菌药物使用情况,评价抗菌药物使用的合理性,为抗菌药物管理提供依据。方法采用回顾性调查方法,调查2010年3-4月的出院病历1863份,对抗菌药物的使用情况进行统计分析。结果 1863份住院病历中有1087份使用了抗菌药物,抗菌药物使用率为58.4%,其中手术科室抗菌药物使用率为70.9%,非手术科室抗菌药物使用率为49.8%;治疗用药占56.9%,预防用药占43.1%;经验用药占98.6%,依据药敏结果用药占1.4%,不合理用药主要表现在起点过高、越级使用、选药不当、经验用药率过高等。结论加强抗菌药物相关知识的培训学习,严格掌握用药原则,强化抗菌药物使用管理制度和临床药师定期下临床制度的落实,加强临床用药监管等措施,是合理使用抗菌药物的关键。

OBJECTIVE To understand the use of antibiotics and evaluate the rationality of using antibiotics,so as to provide evidence for the management of antimicrobial agents′ application.METHODS A total of 1863 medical records of the patients who were discharged from Mar to Apr 2010 were retrospectively investigated.Statistical analysis of the use of antibiotics was performed.RESULTS Totally 1087 of 1863 medical records have used antibiotics with the utilization ratio of 58.4%,70.9% in surgery department,49.8% in non-surgical departments.Drugs used with the purpose of treatment accounted for 56.9%,and 43.1% for prophylaxis;experience medication accounted for 98.6%.The use on the basis of drug susceptibility accounted for 1.4%.Unreasonable use of antibiotics had the following causes： high threshold,cross-class use,improper drug selection,and overuse of experience medication.CONCLUSION It is the key of the rational use of antibiotics to enhance the knowledge of antimicrobial agents,strictly grasp principles of administration,strengthen the management of use of antibiotics and pharmacists shall go to the clinic on a regular basis.