政策干预对综合医院抗菌药物日使用率的影响

Impact of antimicrobial management guideline on the daily antimicrobial use rate in a general hospital

目的评价抗菌药物管理措施对某院住院患者抗菌药物日使用率的影响。方法采用横断面调查方法,对该院2010—2012年某日住院患者抗菌药物使用情况进行调查分析。结果 2010—2012年抗菌药物日使用率分别为65.40%、42.09%和26.74%,病原学送检率分别为22.53%、35.74%和41.74%,差异均有统计学意义(χ2trend值分别为266.42、29.02,均P<0.01)。2010—2012年抗菌药物单一用药率分别为83.72%、80.27%和93.41%,各年均以单一用药为主;二联和≥三联用药比例下降。2010—2012年消化内科、心血管内科、血液肿瘤科、神经内科、普通外科、神经外科、骨科、产科、儿科及眼科各科室抗菌药物使用率呈下降趋势,差异均有统计学意义(均P<0.01)。结论抗菌药物政策干预降低了该院抗菌药物日使用率,提高了病原学送检率。

Objective To evaluate the effect of antimicrobial management guideline on the daily antimicrobial use rate in a general hospital.Methods An one-day point-prevalence survey on antimicrobial use in hospitalized patients was conducted in 2010,2011,and 2012 by means of cross-sectional investigation method.Results The daily utiliza-tion rate of antimicrobial agents in 2010,2011,and 2012 was 65.40% ,42.09% and 26.74% respectively,the rate of the submission of specimens for bacterial culture was 22.53% ,35.74% and 41.74% respectively（χ2 trend= 266.42, 29.02,respectively,bothP〈0.01）. The utilization rate of single drug was 83.72% ,80.27% and 93.41% respec-tively. the utilization rate of both two-drug and more than three-drug combination kept a downward tendency. The utilization rate of antimicrobial agents in several departments（digestive internal medicine,cardiovascular,hematolog-ical tumor,neurology,general surgery,orthopedics,obstetrics,pediatrics,and ophthalmology）showed a decreasing tendency（all P〈0 .0 1 ）.Conclusion The implementation of antimicrobial management guideline has remarkably re-duced the daily antimicrobial use rate,and increased etiological detection rate for therapeutic antimicrobial use.