住院患者抗菌药物使用回顾性调查及管理干预

Retrospective investigation of use of antibiotics by hospitalized patients and management interventions

目的了解住院患者抗菌药物使用情况,为制定管理干预措施提供科学依据。方法采样回顾性调查的方法,对2011年第一季度住院患者抗菌药物使用进行调查。结果 1612例住院患者中有1067例使用过抗菌药物,抗菌药物使用率为66.19%,其中单一用药占49.67%,二联用药占40.49%,≥三联占9.84%;治疗用药占43.39%,预防用药占50.42%,治疗加预防占6.19%;抗菌药物使用率与患者付费方式有关(χ2=6.313,P=0.013);不合理应用主要表现在用药无指征或预防用药指征过宽,不适当的联合用药,病原学送检率低等。结论针对抗菌药物使用现状,采取加强组织管理、完善规章制度、开展知识培训、严格检查考核等有效干预措施,以提高临床合理用药水平。

OBJECTIVE To explore the application of antibiotics,in order to provide bases for formulating scientific management interventions.METHODS A retrospective survey of the application of antibiotics was conducted for the hospitalized patients from Jan to Mar 2012.RESULTS There were 1067 among 1612 cases applying antibiotics with the application rate of 66.19%,including the single antibiotics treatment in 49.67%,two kinds of antibiotics in 40.49% and three or more in 9.84%.Among those who had received antibiotics,43.39% were used for therapeutic purposes while 50.42% for prophylaxis,and 6.19% for both therapy and prophylaxis.There was statistical difference among the inpatients with different payment（χ2 =6.313,P=0.013）.The irrational application of drugs mainly showed in lack of application indications or unreasonable expansion of indications for prophylactic antibiotics,irrational combination usage,and low examination rate of etiology.CONCLUSION According to the status of antibiotics usage,the interventions available such as enhancing organization management,perfecting bylaw,developing the training of the professional knowledge,strengthening inspecting and so on should be adopted to improve the level of reasonable application of antibiotics.