干预措施对住院患者抗菌药物应用效果分析

Result analysis of interventions on inpatients underwent with antimicrobial drugs

目的探讨干预措施对住院患者抗菌药物应用的影响,并对结果进行分析,促进抗菌药物在临床的合理应用。方法回顾性分析医院2011年行政干预前的14 436份病历和2012年干预后的17 242份病历资料,研究使用抗菌药物的使用率、使用强度、微生物样本送检率以及干预前后Ⅰ类切口手术用药术前<2h、术中、术后开始等不同时机和Ⅰ类切口总用药时间等指标,并对干预前后抗菌药物使用进行统计分析。结果措施干预后,抗菌药物使用率及标本送检率外科患者分别52.2%、53.7%,内科患者分别36.9%、43.9%;外科和内科抗菌药物使用强度分别为42.6和37.5DDDs,与干预前比较,差异有统计学意义(P<0.05);行政干预后Ⅰ类切口手术用药的应用时机和时间也更为合理。结论医院加强干预对住院患者的抗菌药物的应用是有效的,积极开展医疗服务阳光用药工程实施方案,能有效地控制抗菌药物的滥用,可以规范临床医师合理选择抗菌药物。

OBJECTIVE To explore the effects of administrative interventions on inpatients with the antimicrobial drugs and analyze the results, and promote the rational use of antimicrobial drugs in clinics. METHODS A retrospective analysis was conducted on a total of 14436 cases before administrative intervention in 2011 and 17242 cases after intervention in 2012, and the index of use rate and intensity, microbial specimen inspection rate, the preoperative surgery medication of Class I Incision before and after intervention 〈 2 h, different timing intraoperative and postoperative and total medication time, etc were investigated, and the condition of the use of antimicrobial drugs before and after intervention were statistically analyzed. RESULTS After the intervention of administrative measures, antimicrobial drug use rate was 52. 2%, and the detection rate of specimens were 53.7%, while was 36.9% and 43.9% in the department of internal medicine, respectively. The use intensity of antimicrobial drugs in department of surgery and internal medicine were 42.6 and 37.5DDDs respectively, and the difference compared with that before intervention was statistically significant（P〈0.05） The application timing of medication on class I incision and total medication time became more reasonable. CONCLUSION Strengthening hospital administration intervention is effective for the application of antimicrobial drugs in hospitalized patients, and the implementation of medical service of sunlight medication project actively could effectively control the abuse of antimicrobial drugs and regulate the clinicians rational choice of antimicrobial drugs.