我院2013年抗微生物药物类基本药物应用分析

Analysis of the Application of Antimicrobials Essential Medicines in Our Hospital in 2013

目的：为医疗卫生机构有效降低药品费用提供参考。方法：随机抽取我院2013年1-12月的部分门诊、急诊及住院原始处方，采用回顾性调查分析方法，对照《国家基本药物目录》（2012年版）、《国家基本药物重庆市补充药物目录》（2013年版），对抗微生物药物类基本药物的应用情况进行统计分析。结果：共抽取103590份样本处方，其中使用（含）抗微生物药物处方达26208份，所占比例为25．3％；在全部抗微生物药物处方中有18581份处方使用了基本药物，所占比例为70．9％，处方金额为981．8万元，所占比例为42．5％；用药频度（DDDs）排序前10位抗微生物药物品种均为基本药物，其中排序前7位的均是注射用头孢菌素（限制使用级有5个）；所有进入基本药物目录的O．5～1．5g规格的注射用头孢菌素在重庆药交所的挂网价，除头孢美唑和头孢米诺较高外，其余品种均为0．58～2．92元／瓶。结论：政府部门应严格监管药品价格，尽量避免同类高价药品进入基本药物目录；临床使用抗微生物药物时应注意合理选用价格较低的同类基本药物，严格监督和执行抗菌药物分级管理制度，从而有效降低药品费用。

OBJECTIVE： To provide reference for effective reduction of drug costs in medical institutions. METHODS： Outpa- tient, emergency and inpatient prescriptions were collected from our hospital during Jan.-Dec. in 2013. By retrospective analysis, conforming to National Essential Medicine List （2012 edition） and National Essential Medicine Chongqing Supplement List （2013 edition）, the application of antimicrobials essential medicines was analyzed statistically. RESULTS： 103, 590 prescriptions had been sampled in total, among which there were 26, 208 prescriptions with anti-microbial drugs, accounting for 25.3%. Among all prescriptions with antimicrobials, there were 18, 581 prescriptions of antimicrobials essential medicine, accounting for 70.9%. The amount of prescription was 981.8 ten thousand yuan, accounting for 42.5%. Top 10 antimicrobials in the list of DDDs were essen- tial medicines, and top 7 medicines were Cephalosporin for injection, among which 5 were restricted for use. The registered prices of Cephalosporin for injection （0.5-1.0 g） included in the essential medicine list of Chongqing drug exchange were 0.58 to 2.92 yu- an/injection, except for cefmetazole and cefminox. CONCLUSIONS： The government should supervise medicine price strictly to avoid similar medicines with high price included in essential medicine list as far as possible. On the one hand, similar essential med- icine with low price should be considered when antimicrobials are used in the clinic; on the other hand, level-to-level administra- tion system for anti-bacterial agents must be strictly supervised and carried out so as to effectively reduce medicine costs.