抗菌药物使用综合干预及其效果评估

Comprehensive Intervention and Effect Evulation of Hospital Antimicrobial Usage

目的:评估抗菌药物使用综合干预效果,为规范医院抗菌药物合理应用提供参考。方法:干预措施:采取药学干预和行政干预相结合的方式,对医院抗菌药物使用进行综合干预。效果评估:分别调取我院2012年6月-2013年5月(干预前)、2013年6月-2014年5月(干预后)使用过抗菌药物的病区及门诊病历作为对照组和干预组,从综合干预前后抗菌药物的使用率、使用强度(DDD,Daily Defined Dose)以及特殊使用级抗菌药物的送检率、抗菌药物联用情况等几个方面评估综合干预效果。结果:干预组抗菌药物的平均使用率、平均使用强度分别为59.18%和35.19 DDD,低于对照组的71.39%和45.64 DDD;特殊使用级抗菌药物的送检率由26.65%上升至81.58%;抗菌药物联合用药情况更趋于合理。结论:采取综合干预措施可以降低门诊和病区病例抗菌药物的使用率、使用强度;提高特殊使用级抗菌药物的送检率,抗菌药物联用更趋于合理。

Objective： To investigate and analyze comprehensive intervention for the hospital antimicrobial usage and to promote and regulate the rational use of antibiotics in the hospital. Methods： Comprehensive intervention for antimicrobial drug usage Was performed which combined pharmaceutical and administrative interventions. Medical records from wards where antimicrobial agents were used and clinics from June 2012 to May 2013 （before intervention） and from June 2013 to May 2014 （after intervention） were collected and assigned as the control group and the intervention group respectively. The comprehensive intervention effects were evaluated from aspects such as usage rate, usage intensity before and after the intervention, delivery rate of antimicrobial drugs for special use and combined use of antimicrobial drugs. Results： The average usage rate and average intensity of antimicrobial drugs were 59.18% and 35.19 DDD respectively in the intervention group while they were lower than 71.39%, 45.64 DDD in the control group. The delivery rate of antimicrobial agents for special use increased from 26.65% to 81.58%. Combination therapy of antimicrobial drugs tended to be more reasonable. Conclusion： Comprehensive intervention can reduce the antimicrobial usage rate and intensity in outpatient clinics and wards and improve the delivery rate of antimicrobial drugs for special use, and the antimicrobial combination therapy tends to be more reasonable.