特殊使用级抗菌药物点评系统的开发与应用

Study on the Development and Application of Comment System for Antimicrobial Agents at Special Use Level

目的:开发特殊使用级抗菌药物点评系统,提高特殊使用级抗菌药物的临床使用水平,降低细菌耐药率。方法:利用易语言和数据库技术,建立特殊使用级抗菌药物合理性评分表,特殊使用级抗菌药物点评系统。对2010年1-6月和2013年1-6月特殊使用级抗菌药物使用病历的越级使用情况、病原微生物送检情况、抗菌药物使用合理性(药物选择、用法用量、联合用药)、会诊单例数、平均使用金额和特殊使用级抗菌药物使用强度进行回顾性统计并分析。结果:系统实现了特殊使用级抗菌药物处方点评功能,系统应用后抗菌药物越级使用率从14.9%下降至2.3%(P=0.000);病原微生物送检率从47.3%提高至93.9%(P=0.000);抗菌药物选择合理率从88.1%上升至96.9%(P=0.000);会诊单申请率从40.2%提高至97.3%(P=0.000)。特殊使用级抗菌药物使用强度从164.3下降至84.2(P=0.042);平均使用金额从1 210.4元下降至964.1元(P=0.032)。结论:特殊使用级抗菌药物点评系统提高了特殊使用级抗菌药物管理水平,有效地降低了特殊使用级抗菌药物费用支出。

Objective： To develop a system for the comment on antimicrobial agents at special use level , so as to improve the clinical use of such antimicrobial agents and reduce the resistant rate of bacteria . Methods： Using easy-language and database technology to establish a comment system by means of score sheet for rationale use of such antimicrobials . A retrospective analysis was conducted on the unreasonable use of medical record by exceeding power of antimicrobial agents at special use level , the submission rate for testing of pathogenic microorganisms , ra-tional drug use （ including drug choice , usage and dosage , combined drug use ） , numbers of single case of consulta-tion , the average amount of consumption and use intensity of antimicrobial agents during Jan . to June of 2010 and Jan . to June of 2013 . Results： The system realized the prescription comment function of antimicrobials at special use level . After adoption of the system the unreasonable application rate of antimicrobials by exceeding power de-creased from 14 . 9% to 2 . 3% （ P = 0 . 000 ） , the submission rate for testing of pathogenic microorganisms increased from 47 . 3% to 93 . 9% （ P = 0 . 000 ） , the reasonable selecting rate increased from 88 . 1% to 96 . 9% （ P = 0 . 000 ） , the consultation application rate increased from 40 . 2% to 97 . 3% （ P = 0 . 000 ） , use intensity of antimicrobial agents＆amp;nbsp;at special use level decreased from 164 . 3 to 84 . 2 （ P = 0 . 043 ） , the average consumption amount decreased from 1 210 . 4 to 964 . 1 yuan （ P = 0 . 032 ） . Conclusion： The establishment of the comment system for antimicrobial agents at special use level improved the management and reduced effectively the expense of antibacterial drugs with special use level .