抗菌药物处方和不合理典型处方干预的效果分析

Effects of Intervention Measures for Antibiotics Prescriptions and Unreasonable Use of Antibiotics in Typical Prescriptions

目的:探讨我院门急诊抗菌药物处方管理与干预措施实施的效果。方法:分别调查我院2012年7-12月门急诊抗菌药物处方10 226张(含不合理典型处方75张)以及2013年1-6月门急诊抗菌药物处方11 051张(含不合理典型处方70张),分别作为干预前和干预后数据。比较抗菌药物不合理应用的指标变化,检验干预效果。结果:干预后抗菌药物处方合格率明显上升,由干预前的63.70%上升到干预后的75.50%;抗菌药物联合使用率显著下降,由干预前的8.99%下降到干预后的7.15%;不规范处方和超常处方大大减少,分别由干预前的44.30%和22.14%,下降到干预后的38.72%和11.66%;平均每张不合理典型处方不合理用药表现次数下降,由干预前的2.04人/次下降到干预后的1.54人/次,差异均具有统计学意义(P<0.05)。主要不合理应用具体指标有改善,其他仍需继续改进。结论:合理的干预措施使抗菌药物应用合理性全面提升是可行的,但我院抗菌药物处方合格率有待进一步提高。

OBJECTIVE： To explore the effect of the management of outpatient and emergency antibiotic prescriptions and the implementation of interventions measures in our hospital. METHODS： 10 226 outpatient and emergency antibiotics prescriptions （containing 75 typical prescriptions） from Jul. 2012 to Dec. 2012 and 11 051 outpatient and emergency antibiotics prescriptions （containing 70 typical prescriptions） from Jan. 2013 to Jun. 2013 were investigated in our hospital before and after intervention. Changes of the indicators of unreasonable antibiotics use were compared to inspect intervention effect. RESULTS： After interven- tion, the pass rate of antibiotic prescriptions increased significantly from 63.70% before intervention to 75.50% after intervention. The pass rate of antibiotics combination was significantly decreased from 8.99% before intervention to 7.15 % after intervention. The non-standard prescriptions and the supemormal prescriptions were greatly reduced from 44.30% and 22.14% before interven- tion to 38.72 % and 11.66 % after intervention. Average times of irrational drug use per prescription was decreased from 2.04 person/ times to 1.54 person/times. The differences had statistical significance （P〈0.05）. The specific indicators of main unreasonable appli- cation were improved, the others needed to be improved continually. CONCLUSIONS： It is feasible to improve reasonable use of antibiotics by intervention measures. But the pass rate of antibiotic prescriptions in our hospital should to be further improved.