抗菌药物不合理应用的成因及干预情况分析

Causes of Irrational Use of Antibacterial Drugs and Clinical Pharmacists' Intervention on the Irrational Use of Antibacterial Drugs

目的:探讨抗菌药物不合理应用持续存在的原因及临床药师的干预其临床应用的作用。方法:对2011—2013年165例抗菌药物不合理应用、临床药师干预及被采纳的情况进行分析。结果:临床药师干预的不合理用药165例中,有105例(63.03%)被医师采纳。围术期预防用药采纳率达到100%;门诊及非手术科室的医师对禁忌证、药物相互作用、用法用量、溶媒选择以及根据患者肝肾功能选择药物等方面的建议基本上采纳;对联合不适宜、遴选不适宜、未规范诊断、无指征用药、适应证不适宜等方面的建议采纳程度很低。结论:临床药师干预抗菌药物不合理应用确实起到了一定的作用。医院还须加强行政干预力度,进一步规范抗菌药物临床应用行为,开展抗菌药物合理应用教育,才能有效促进抗菌药物的合理应用。

OBJECTIVE：To investigate the causes of the persistent irrational use of antibacterial drugs and the role of clinical pharmacists in the intervention on the clinical use of antimicrobial drugs.METHODS：The irrational use of antimicrobial drugs and the intervention of clinical pharmacist and the adoption of their advices in 165 cases between 2011 and 2013 was analyzed.RESULTS：Of the total 165 cases undergoing intervention,the advices of clinical pharmacists were adopted in 105 cases （63.03%）.Perioperatively,the advices were adopted in 100%.The advices on contraindications,drug interactions,dosage ＆ administration,solvent selection and the recommendations on the choice of drugs based on patients＇ hepatorenal function were mostly adopted by physicians; however,the advices on the improper drug combination,inappropriate drug choice,nonstandard diagnosis,medication in the absence of indications and unsuitability in indications were scarcely adopted.CONCLUSIONS：The clinical pharmacists＇ intervention played a role in the irrational use of drugs.Hospitals must strengthen administrative intervention efforts to further standardize the clinical use of antimicrobial drugs,conduct education on the rational use of antimicrobial drugs education in order to effectively promote their rational use.