ICU抗菌药物使用现状调查

Investigation on the use of antibacterials in ICU

目的了解医院重症监护病房(ICU)抗菌药物使用现状,为ICU抗菌药物管理提供依据,给临床合理使用提供指导。方法调查2012年4月-2013年3月ICU出院的335例患者,分析其抗菌药物的使用,采用Excel计算DDDs、AUD、特殊使用级使用率、针剂使用率、抗菌药物使用率以及病原菌送检率等。结果 ICU出院患者共335例,291例患者使用抗菌药物,使用率为86.87%;其中235例患者进行临床微生物检查,标本送检率为80.76%;抗菌药物特殊使用级使用率为34.85%,限制使用级使用率为47.38%,针剂使用率为89.69%,抗菌药物使用强度为123.05DDDs;抗菌药物临床使用以头孢哌酮/舒巴坦和哌拉西林/他唑巴坦使用最多,使用强度分别为24.03DDDs和13.25DDDs;特殊使用级抗菌药物以糖肽类和碳青霉烯类为主,使用强度分别为14.63DDDs和13.56DDDs。结论 ICU抗菌药物使用率高、使用强度大,需要更严格掌握抗菌药物的使用指征,最大限度降低抗菌药物使用强度,使抗菌药物使用更加合理。

OBJECTIVE To understand the use of antibacterials in ICU,so as to provide guidance on the management of antibacterials and the way of using antibacterials rationally.METHODS A total of 335 patients discharged from ICU were collected from Apr.2012 to Mar.2013 to analyze the usage of antibacterials.The DDDs,AUD,usage rate of special use level,injection,antibacterials and inspection rate of pathogenic bacteria were calculated by Excel.RESULTS Three were 335 patients discharged from ICU,and there were 291 patients used antibacterials,and the usage rate was 86.87%,among which,235 patients made clinical microbiology test,and the delivery rate was 80.76%.The usage rate of antibacterials for special use was 34.85%,the usage rate of antibacterials for limit use 47.38%,the usage rate of injection 89.69%,and antibacterial use density was 123.05 DDDs.The use of cefoperazone/sulbactam and piperacillin/tazobactam were at the top two,and the antibacterial use density were 24.03 DDDs and 13.25 DDDs.In special level of antibacterials,glycopeptide and carbapenem made main part,the antibacterial use density were 14.63 DDDs and 13.56 DDDs.CONCLUSIONS The usage rate of antibacterials and antibacterial use density are high in ICU,so we should make more strict control of indications of antibacterials to reduce the antibacterial use density,make antibacterials use much more reasonable.