我国抗菌药物使用与监管现状访谈分析及政策建议

Interview Analysis and Policy Suggestion on Antimicrobials Use and Supervision in China

目的 分析我国抗菌药物使用与监管存在问题,提出政策建议.方法 设计结构式访谈提纲,分别对卫生政策制定者、医院管理者、医生、患者、卫生政策研究者以及医药企业工作者等共计291人开展访谈,对访谈结果进行统计分析.结果 85.7％的地方卫生行政部门和46.7％的地方药监部门受访者认为我国已上市的抗菌药物品种过多;了解抗菌药物知识的渠道主要是文献、学术会议和培训,但有40％的地方药监部门受访者和14.3％的地方卫生行政部门受访者通过医药企业了解抗菌药物知识;约60％的地方卫生行政部门受访者和80％的地方药监部门受访者认为我国抗菌药物监管不如发达国家严格;73.3％的院长和46.7％的中层管理人员兼职临床工作;约5％的医生从未接受过合理用药培训,约10％认为抗菌药物应用指南不符合国情、操作性不强.结论 我国应适当控制抗菌药物品种数量,加强抗菌药物知识宣传与培训,完善抗菌药物监管体系,强化抗菌药物应用指南的可操作性等.

Objective To analyze the problems of antimicrobials use and supervision in China,and to propose policy suggestions.Method The outline of structured interview was designed to interview of health policy makers,hospital managers,doctors,patients,health policy researchers and pharmaceutical enterprise workers respectively,and the result of interviews was analyzed.Result There were 85.7％ regional health administrative department interviewees and 46.7％ regional drug administrative department interviewees who thought too many antimicrobials in market.On the access to antimicrobial knowledge,the main source included literature,academic conferences and training.However,there were still 40％ regional drug administrative department interviewees and 14.3％ health administrative department interviewees getting information from pharmaceutical enterprises; 60％ health administrative department interviewees and 80％ drug administrative department interviewees thought that antimicrobials supervision in China was not as strict as that in other countries; 73.3％ hospital directors and 46.7％ middle management still did clinical work; approximately 5％ doctors had never got trained about how to use drug properly; 10％ doctors thought that application guideline for antimicrobials by Ministry of Health was not accord with the situation of China and was poor implemented.Conclusion Measures should be taken including to take appropriate control of categories and quantity of antimicrobials; to step up publicity and training of antimicrobials knowledge progressively ; to continue to improve antimicrobials supervision system and carry out fine management ; to strengthen the operability of application guideline of antimicrobials.