2010-2013年某三甲医院住院患者抗真菌药物应用分析

Analysis on the utilization of antifungal agents in in-patients in a third-grade and class-A hospital during 2010 to 2013

目的:分析我院2010 2013年住院患者抗真菌药物使用情况及其变化趋势,为临床合理使用抗真菌药物提供参考依据。方法:采用消耗金额和用药频度(DDDs)排序法对我院2010-2013年住院患者抗真菌药物的使用情况进行统计分析,并计算药物的使用强度(AUD)和排序比。结果:2010-2013年我院抗真菌药物的消耗金额呈逐年上升的趋势,年平均增长率为24.14%。4年来吡咯类抗真菌药的消耗金额2010—2012年占第1位,2013年略低于棘白菌素类占第2位。吡咯类抗真菌药物在我院真菌治疗中占主导地位,其中伏立康唑的消耗金额逐渐取代伊曲康唑位居第1位;而伊曲康唑的用药频度一直占第1位。抗真菌药的用药强度呈下降趋势。结论:我院住院部抗真菌药物消耗金额所占抗感染药物金额比例呈上升趋势,用药强度呈下降趋势。住院患者抗真菌药物的使用结构、用药强度基本合理。伊曲康唑和伏立康唑仍是住院患者真菌感染的主要治疗药物,棘白菌素类抗真菌药的治疗效果也逐渐得到临床认可。

Objective：To analyze the utilization of antifungal agents in patients admitted to the First Hospital Affiliated to the Chinese PLA General Hospital during 2010 to 2013,and to provide references for clinical drug use.Methods：The data on utilization of antifungal agents in patients admitted to the First Hospital Affiliated to the Chinese PLA General Hospital during 2010 to 2013 were analyzed by sequencing the sales expenditure and defined daily dose system（DDDs） of antifungal agents,the antibacterial use density（AUD） and sequenced ratio were calculated.Results;During 2010 to 2013,antifungal sales expenditure showed an increasing trend,and the annual average growth rate was 24.14%.During 2010 to 2012,the annual average sales expenditure of pyrrole antifungal drugs was in the first place,and it was replaced by echinocandins in 2013.Pyrrole antifungal drugs were dominantly used in anti-fungi treatment.The sales expenditure of voriconazole gradually replaced itraconazole to become the first.However,the itraconazole kept on the top of DDDs list.The drug use intensity of antifungal agents showed a declining trend in these years.Conclusions：The sales of antifungal agents in in-patients showed a steady raise during 2010 to 2013 in our hospital.However,the drug use intensity is on the decline.In general,the structure and intensity of utilization of antifungal agents were rational on the whole.Itraconazole and voriconazole are still the major antifungal agents in the treatment of fungal infections of inpatients.At the same time,the treatment effectiveness of echinocandins is gradually recognized by clinicians.