2009-2011年国家基本药物制度对北京社区抗感染药物合理应用的影响评价

Evaluation of Influence of National Essential Drug System on Rational Use of Antibacterials in Community from Beijing Area during 2009-2011

目的:评价国家基本药物制度对北京社区卫生服务机构抗感染药物合理应用的影响,为促进社区抗感染药物的合理应用及基本药物目录的定期调整提供参考。方法:对北京市4家社区卫生服务机构2009-2011年处方进行抽样,统计、分析数据并对抗感染药物进行门诊总治疗人次日(TPD)排序。结果:国家基本药物目录及相关政策实施以后,受访社区卫生服务机构处方数量、金额增长明显,而其中的抗感染药物处方数量、金额所占比例明显降低;大部分抗感染类基本药物的TPD排序稳中有升,非基本药物、不良反应较多的药物使用量有所下降,注射用抗感染药物TPD排序相对集中,左氧氟沙星位列第1位且TPD值较大。结论:国家基本药物目录及相关政策实施促进了社区抗感染药物的合理应用,该目录的调整应根据社区实际使用情况实行优胜劣汰。

OBJECTIVE：To analyze the influence of national essential drug system on rational use of antibacterials in community health service institutions,and to provide reference for the regulation of essential drug list and rational use of antibacterials in community.METHODS：The prescriptions of 4 community health service institutions were collected and analyzed statistically in Beijing during 2009-2011,and TPD of antibacterials were sorted.RESULTS：After the implementation of the national essential drug list and related policy,the number and amount of prescription were significantly increased,while the number and amount proportion of antibacterial prescription were significantly reduced.TPD sort of most of antibacterials essential drug had increased steadily;those of non-essential drugs and significant adverse reaction-inducing drugs were declined;antibacterials for injection was relative concentrated;levofloxacin ranked the first place and the TPD of it was the greatest.CONCLUSION：The implementation of the national essential drug list and related policy has promoted the rational use of antibacterials in community,and the list should be adjusted according to the situation of drug use in community.