某三甲医院门诊与住院患儿用药结构特点与差异及合理性分析

The Characteristic and Difference of Drugs Use between Outpatients and Inpatients of Pediatrics and Rationality Analysis in a Grade Three Hospital

目的:通过对某三甲医院儿科使用的抗菌药物、呼吸系统药物和消化系统药物现状的抽样调查,对比门诊与住院患儿用药特点与差异并进行相关因素分析,以期促进儿科用药的合理性与安全性。方法:随机抽取某院儿科2011年2月至2012年9月门诊处方2 400张和2010年6月至2012年5月儿科住院电子病历1 600份,采用DDDs排序法对数据进行统计分析。结果:门诊与住院患儿在给药途径、给药剂量、给药剂型以及药品种类选择上存在一定的差异。给药途径门诊患儿以口服为主,住院患儿以静脉滴注为主;部分呼吸系统药物用药剂量过大,住院患儿抗菌药物的使用起点选择较高,使用率、联合用药率也较高。结论:虽然该院儿科用药结构基本合理,但调查结果显示静脉给药方式在儿童用药中已逐步成为主流,为保证其用药的安全性,抗菌药物的合理选用(或联用)以及儿童用药剂量科学规范化值得重视与研讨。

Objective： To promote the safety and rationality of pediatric drug use by comparing the drug using characteristics and analyzing the related reasons. Methods： Two thousands and four hundred pediatric prescriptions of outpatient department from February to September in 2012 and 1,600 electronic prescriptions of inpatient department from June 2010 to May 2012 were selected randomly. The data were analyzed with DDDs ranking methods. Results： There existed differences of drug using characteristics in administration routes, doses and types of drugs between the outpatients and inpatients in pediatrics. The common administration routes of drugs were oral administration in outpatients and injection in inpatients. There were some irrational drug uses, such as improper selection of antibiotics, high use rate and combination rate of antibiotics, and overdose of some respiratory system drugs. Conclusions： Even though the drugs＇ application of our pediatrics seems reasonable, injection is the main administration route. The use of antibiotic drugs and the dose of pediatric drugs should be paid attentions.