我院2012年抗菌药物专项整治期间抗菌药物的应用分析

Application analysis of antibacterials during the period of special rectification in our hospital in 2012

目的:调查我院2012年抗菌药物专项整治期间不同阶段抗菌药物的应用情况,为后续管理提供参考。方法:采用回顾性调查法,对2012年5–7月(整治前期),2012年8–10月(整治中期),2012年11月–2013年1月(整治后期)抗菌药物用药金额、用药频度(DDDs)、抗菌药物使用强度(AUD)等数据进行统计分析。结果:抗菌药物专项整治后期和整治中期抗菌药物的DDDs较整治前期分别下降19.83%和15.54%,AUD下降了17.54%和14.15%。人均使用抗菌药物费用由903.52元下降到843.65元,人均下降59.87元。整治后期和整治中期的抗菌药物使用率较整治前期下降了17.60%和8.75%。分级管理制度被严格执行后,我院特殊级抗菌药物管理成效明显,其中整治后期和整治中期的特殊级抗菌药物使用率比整治前期下降了49.06%和40.17%,特殊级抗菌药物使用强度分别下降了20.08%和12.95%。Ⅰ类切口手术的抗菌药物预防使用率从整治前期22.22%下降到整治中期的16.67%和整治后期的14.58%,均符合Ⅰ类切口抗菌药物使用率≤30%的规定。整治期间,微生物标本送检率未见明显变化,且检出阳性率较低。结论:本次抗菌药物专项整治有助于促进我院抗菌药物的合理使用,但是要提高我院抗菌药物临床合理应用的水平,还必须制定抗菌药物临床应用管理的长效机制。

Objective： To investigate the clinical application of antibacterials in our hospital during the different periods of special rectification in 2012, so as to provide reference for follow-up management. Methods： The special rectification period was divided to three stages： early stage （May to July 2012）, middle stage （August to October 2012） and last stage （November 2012 to January 2013）. Data such as the consumption sum, the frequency of medication （DDDs） of antibacterials and the antibiotics use density （AUD） were analyzed in different stages retrospectively. Results： DDDs decreased by 19.83% and 15.54%, AUD decreased by 17.54% and 14.15%, and the utilization rate of antibacterials decreased by 17.60% and 8.75% in the last stage and middle stage of special rectification compared with that in the early stage, respectively. The mean expense of antibacterials decreased from 903.52 Yuan to 843.65 Yuan （decreasing by 59.87 Yuan）. The use of special level antibacterials was improved obviously after classified management and special rectification, the utilization rate of special level antibacterial agents decreased by 49.06% and 40.17%, and AUD decreased by 20.08% and 12.95% in the last stage and middle stage compared with that in the early stage, respectively. The utilization rate of prophylactic use of antibacterials in class I incision operation decreased from 22.22% in the early stage to 16.67% in middle stage and 14.58% in last stage, which met with the criteria demand of less than 30%. In the period of special rectification, microbiological samples detection rate had no significant change, and the positive detection rate was low. Conclusion： The special rectification can significantly improve the rational use of antibacterials in our hospital, but long-term management mechanism of antibacterial application should be taken to strengthen the rational use of antibacterials.