抗菌药物分级管理评价系统的开发与应用

Research on Development and Application of Evaluation System of Antibacterial Classification Management

目的:开发抗菌药物分级管理评价系统,提高抗菌药物分级管理水平,减少不合理应用。方法:根据WHO-ATC/DDD(世界卫生组织-药物系统分类/限定日剂量)抗菌药物分类表建立药品数据库。通过"计次循环"语句和抗菌药物使用强度计算公式统计抗菌药物使用强度,自动统计分级抗菌药物送检率。对2010年1-6月和2013年1-6月抗菌药物使用病历的越级使用情况、抗菌药物平均使用金额、使用强度和病原微生物送检情况进行回顾性分析。结果:系统应用后越级使用例数从应用前的125例下降至38例(P=0.000);抗菌药物使用强度从87.6下降至44.3(P=0.002);平均使用金额从872.4元下降至659.3元(P=0.001)。非限制类抗菌药物的病原微生物送检率从25.1%提高至40.8%,限制类抗菌药物的病原微生物送检率从32.8%提高至55.5%,特殊类抗菌药物的病原微生物送检率从47.3%提高至93.9%。结论:抗菌药物分级管理评价系统能自动统计与监控抗菌药物分级信息;可提高各级抗菌药物送检率,减少越级使用例数,并降低抗菌药物平均使用金额和使用强度。

Objective：To develop the evaluation system for antibacterial drug classification management,im-prove the management level of antibacterial drug classification and reduce unreasonable drug application.Methods：The drug database was established according to the list of antimicrobial drug classification of WHO-ATC/DDD. The use intensity of antimicrobial agents was calculated through the ＆quot;cycle＆quot; statements and the calculation formula of antimicrobial use strength,and the submission rate for testing of classified antimicrobial drugs was automatically reported. The statistical analysis was made retrospectively on the usage of medical records of antimicrobial drug consumption,pathogens,the average amount of consumption,the using intensity and the submission rate for test-ing of pathogens during Jan. to Jun. of 2010 and Jan. to Jun. of 2013.Results：After the application of the sys-tem,cases of use of antibacterial drugs with exceeding power decreased from 125 to 38（P= 0.000）,the use in-tensity of antimicrobial agents decreased from 87.6 to 44.3（P= 0.002）,the average amount of consumption de-creased from 872.4 to 659.3 yuan（P= 0.001）. The submission rate for testing increased from 25.1% to 40.8% and from 32.8% to 55.5% for non-restricted pathogenic microorganisms and the restricted pathogenic microorgan-isms respectively,and the submission rate for testing of the pathogenic microorganisms of special antibacterial drugs increased from 47.3% to 93.9%.Conclusion：The evaluation system of antibacterial drug classification management can automatically make a statistical analysis and monitor the classification information of antibacterial drugs. It can not only increase the submission rate for testing of various antibacterial drugs,but also reduce the use of antibacte-rial drugs with exceeding power and decrease the average amount of consumption and using intensity.