专项整治前后社区获得性肺炎患者抗菌药物应用分析

Analysis of Antibacterials Use in Patients with Community-acquired Pneumonia before and after Special Rectification

目的:调查抗菌药物专项整治前、后某院社区获得性肺炎(CAP)住院患者抗菌药物的应用情况。方法:采用回顾性方法,查阅2011年6月(整治前)和2012年6月(整治后)某院住院CAP患者的出院病历,对抗菌药物的应用情况进行统计、分析。结果:整治后该院CAP患者平均住院时间由14.54d缩短至12.44d;平均抗菌药物疗程由18.00d缩短到12.67d;抗菌药物的使用强度(AUD)由154.43DDDs/100人/天下降到111.58DDDs/100人/天(P<0.01);抗菌药物平均费用由2690.31元下降至1666.96元(P<0.01);患者出院带药由31例次减少到12例次(P<0.01)。但在指标下降的同时,不按CAP指南选择药物治疗的问题仍然突出。结论:开展专项整治有助于促进抗菌药物应用管理;但医疗机构在控制指标的同时,尚需加强对抗菌药物临床应用合理性的评价。

OBJECTIVE：To investigate the clinical application of antibacterials in hospitalized patients with community-acquired pneumonia （CAP） before and after special rectification.METHODS：By retrospective study,discharged medical records of CAP patients in a hospital were reviewed in Jun.2011 （before special rectification） and Jun.2012 （after special rectification）.The use of antibacterials was analyzed statistically.RESULTS：After special rectification,the average hospitalization days of CAP patients was shortened from 14.54 d to 12.44 d;the average duration of antibacterials was shortened from 18.00 d to 12.67 d;AUD decreased from 154.43 DDDs/100 persons/day to 111.58 DDDs/100 persons/day （P＆lt;0.01）;the average cost of antibacterials was decreased from 2 690.31 yuan to 1 666.96 yuan （P＆lt;0.01）;and the number of discharge medication was decreased from 31 cases to 12 cases（P＆lt;0.01）.While the indicators fell,the problem of drug selection which didn’t followed the guidelines was still outstanding.CONCLUSIONS：The special rectification helps to promote the use and management of antibacterials.However,medical institutions control indicators,at the same time need to strengthen the evaluation of rationality of antibacterials use.