2008—2011年息烽县人民医院抗菌药物应用分析

Antibiotic Use in Xiefeng County People's Hospital During 2008-2011

目的:了解我院抗菌药物临床应用情况,为临床合理选用抗菌药物提供参考和用药信息。方法:采用回顾性分析方法,提取医院药品信息管理系统中2008年1月—2011年12月门诊药房和住院药房抗菌药物原始处方数据、用量与销售金额,并从医院病案室提取各年住院患者数和平均住院天数。利用Excel 2003对我院2008—2011年抗菌药物的用量、销售金额、用药频度(DDDs)、限定日费用(DDC)、抗菌药物使用强度(AUD)、药物利用指数(DUI)等进行统计、分析。结果:我院门诊抗菌药物销售金额占药品总销售金额比例维持在6%以下,较住院药房抗菌药物销售金额占药品总销售金额比例低,且抗菌药物处方量占门诊总处方量比例呈逐年下降趋势。门诊患者注射用头孢菌素类药销售金额呈现较高的增长趋势,其中注射用头孢唑肟增幅最大,年均增长率(CAGR)达728.33%;口服制剂以硝基咪唑类药奥硝唑片增幅最大,CAGR达257.67%;罗红霉素胶囊与阿莫西林胶囊的DDDs排序居前列。DDC排序居前3位的抗菌药物则为注射用美洛西林/舒巴坦钠、注射用阿洛西林和注射用头孢硫脒。而住院药房抗菌药物销售金额占药品总销售金额比例由2008年的30.30%降至2011年的13.89%,下降近2倍,且抗菌药物处方量占总处方量比例呈逐年下降,抗菌药物使用强度(AUD)由2008年的75.11 DDD降至2011年的54.42 DDD。住院药房注射用头孢菌素类销售金额占主导,其中注射用头孢硫脒增幅最大,CAGR达317.76%;第3代头孢菌素类注射用头孢噻肟和注射用头孢曲松DDDs排序居前列;第2代头孢菌素注射用头孢孟多DDC排序居首位。结论:我院抗菌药物应用须进一步规范,严格执行抗菌药物分级管理制度,确保患者得到有效治疗。

OBJECTIVE：To investigate the antibiotic use in our hospital so as to provide reference for clinical rational use of antibiotics and provide information about drug use. METHODS ： By a retrospective analysis, the original antibiotic prescription data, consumption amount and sum of antibiotics in both outpatient and inpatient pharmacies between Jan. 2008 and Dec. 2011 were collected from hospital drug information management system; and the data including number of inpatients and their average hospital stay in each year were retrieved from hospital medical records room. The consumption amount, consumption sum, DDDs, DDC （defined daily cost）, antibiotic use intensity （AUD）, drug utilization index （DUI） of antibiotics were analyzed statistically using Excel 2003. RESULTS： The proportion of antibiotics used by the outpatients remained at less than 6% of total in terms of consumption sum, and itwas lower than the proportion of antibiotics used by the inpatients ; furthermore, the proportion of antibiotics in total in terms of prescription amount in the outpatients showed a year-on-year decrease. The consumption sum of cephalosporins for injection used by outpatients showed rapid upward trend, much as in the consumption of ceftizoxime （injection） which showed an average annual growth rate （CAGR） of 728.33% and in the consumption of nitroimidazoles （oral agents） in which ornidazole tablets showed a highest average annual increase growth rate of 257.67% ; roxithromycin capsules and amoxicillin capsules took the lead in terms of DDDs. The top 3 antibiotics on the list of DDC were mezlocillin and Sulbactam sodium for Injection, azlocillin for Injection and cefathiamidine {br Injection. The proportion of antibiotics used by the inpatients decreased from 30. 30% in 2008 to 13.89% in 2011, a decline of nearly 2 times, and the proportion of antibiotics in total in terms of prescription amount in the inpatient pharmacy decreased year by year; the AUD of antibiotics decreased from 75.11 DDD in 2008 to 54.42 DDD in 2011. In the inpatient pharmacy, cephalosporins assumed dominant place in consumption sum, much as in the consumption of cefathiamidine for injection which showed an average annual growth rate （CAGR） of 317.76% ; cefotaxime ibr injection and ceftriaxone for injection （both are the third generation cephalosporins） took the lead on DDDs list; cefamandole for injection （the second generation cephalosporins） took the lead in terms of DDC. CONCLUSION ： The antibiotic use in our hospital needs to be standardized further and it is advisable to strictly abide by graded management system in antibiotic use to ensure effective therapy for patients.