上海崇明地区3家二级综合医院2011年5月至2012年1月抗菌药物利用分析

Analysis of the Utilization of Antibacterials in 3 Second-level Comprehensive Hospitals from Chongming Area of Shanghai during May 2011-Jan.2012

目的:了解上海崇明地区二级综合医院在专项整治过程中抗菌药物的使用及对卫生部"56号文件"的执行情况。方法:采用查阅住院病史、门/急诊处方和床边调查相结合的方法,分为专项整治初期(2011年5-7月)、整治中期(2011年8-10月)、整治后期(2011年11月-2012年1月)3组,对各个时期抗菌药物的使用金额、用药频度(DDDs)等进行统计分析。结果:整治过程中各医院抗菌药物的DDDs总体有所下降(但崇明县第三人民医院有上升趋势),用药结构变化显著,Ⅰ类切口手术预防用药管理改进明显,抗菌药物联用率未见明显变化,治疗性用药的微生物标本送检率均有所提高(崇明分院由整治初期的32.38%上升到整治后期的34.21%,崇明县第二人民医院由25.56%上升到30.33%,崇明县第三人民医院由24.45%上升到28.89%)。结论:专项整治有助于促进各医疗机构抗菌药物的合理使用,但对治疗性用药的管理尚需加强。

OBJECTIVE ： To investigate the application of antibacterials and the implementation of ＂No. 56 Document＂ issued by Ministry of Health in second-level comprehensive hospitals from Chongming area of Shanghai during special rectification. METHODS： By reviewing medical history, outpatient and emergency prescriptions and bedside survey, the utilization of antibiotics were analyzed statistically in respects of consumption sum, DDDs, during early stage （ May - Jul. in 2011 ）, medium stage（Aug.- Oct. in 2011 ） and lat- er stage stage （Dec. 2011- Jan. 2012）. RESULTS： The DDDs ofantibacterials was decreased to some extent in the hospitals dur- ing the special rectification （but that of Chongming County Third People＇s Hospital was increased）. The administration structure was changed greatly. The prophylactic application of antibacterials in type I incision was improved significantly. The rate of combined use of antibacterials had no significant differences although the detection rate of the microbiological specimens increased （that of Chong- ming branch increased from 32.28% at early stage to 24.45% after rectification; from 25.56% to 30.33% in Second People＇s Hospi- tal; from 24.45% to 28.89% in Chongming county Third People＇ s Hospital）. CONCLUSIONS： The special rectification is use- ful to promote rational use of antibacterials. However, measures should be taken to improve the management of antibacterials for therapy.