安徽省蚌埠市第三人民医院2011-2013年抗菌药物消耗量与常见革兰阴性细菌耐药性分析

Utilization of antibacterials and the rate of drug resistance analysis in a hospital during 2011-2013

目的 分析安徽省蚌埠市第三人民医院2011-2013年抗菌药物使用情况及革兰阴性细菌耐药率,为合理使用抗菌药和降低细菌耐药率提供参考依据.方法 采用回顾性调查方法对2011-2013年送检病原菌培养结果、同期各类各种抗菌药物累计使用频度和细菌耐药率进行统计分析.结果 抗菌药物总用药频度逐年减少,从2011年的255 456限定日剂量（DDD）下降到2013年的155 024 DDD,头孢菌素±酶抑制剂类及大环内酯类用量排名逐年升高,三、四代头孢菌素及喹诺酮类用量排名则逐年减少,抗真菌类及碳青霉烯类排名无明显变化,头孢哌酮舒巴坦、头孢呋辛及依替米星排名及用量占比无明显变化,头孢硫脒、头孢吡肟及氨曲南排名及用量占比明显减少.鲍曼不动杆菌及铜绿假单胞菌对哌拉西林他唑巴坦耐药率逐年上升.鲍曼不动杆菌对β-内酰胺类抗菌药呈逐渐耐药趋势.结论 该院的抗菌药物使用频度呈逐年下降的趋势,而部分细菌的耐药率有增加的趋势,需要全社会更加合理使用抗菌药物,以减缓目前的耐药率增长形势.

Objective To analyze utilization of antibiotic drugs and resistance rate of gram negative bacteria in the 3rd People＆#39;s Hospital of Bengbu during 2011-2013,to provide references for clinical rational use of antimicrobial drugs and reduce bacterial resistance.Methods Retrospective investigation method was used to statistically analyze the pathogenic bacteria culture results,antimicrobial cumulative frequency of each categories and results of drug resistance test.Results The total DDDs of antibacterial drugs reduced year by year,down from 255 456 DDD in 2011 to 155 024 DDD in 2013,cephalosporin and enzyme inhibitors and macrolide consumption ranked increased year by year,the three or four generation cephalosporins and quinolones such amount was reduced year by year,antifungal fungi and carbapenem ranking had no obvious change,cefoperazone shubatan,cefuroxime and etimicin ranking and the dosage ratio did not change significantly,the cefathiamidine,cefepime and aztreonam ranking and the dosage ratio was reduced.Bauman acinetobacter and Pseudomonas aeruginosa to piperacillin-tazobactam resistant rate increased year by year,Bauman acinetobacter to beta lactam antibiotics drugs showed a gradual trend of drug resistance.Conclusion The frequency of antimicrobial drug use showed a declining trend in our hospital,and drug-resistant bacteria rate increased,in order to reduce the resistance present form,we need to more rational use antimicrobial agents.