宝鸡地区28家医院专项整治前后抗菌药物应用分析

Analysis of the Clinical Application of Antibiotics in 28 Hospitals from Baoji Area before and after Special Rectification of Antibiotics

目的:评价宝鸡地区28家医院抗菌药物临床应用专项整治活动的效果,为持续推进抗菌药物合理应用提供参考。方法:回顾性分析专项整治前后抗菌药物临床应用各项指标,并对专项整治前后抗菌药物使用频度及销售金额进行统计。结果:经过抗菌药物专项整治,宝鸡地区28家医院抗菌药物品种数已控制在规定范围内,三级医院住院患者抗菌药物使用率及使用强度达标率分别为80%和40%,二级医院分别为34.8%和21.7%;三级医院和二级医院门诊患者抗菌药物使用达标率分别为80%和43.5%;三级医院Ⅸ类切口手术预防使用抗菌药物达标率为40%。以上指标达标率与专项整治前比较差异有统计学意义(P<0.05)。二级医院Ⅸ类切口手术预防使用抗菌药物率仍较高,各级医院微生物送检率均偏低。特殊级抗菌药物在各级医院中的使用率及使用强度均显著下降,与专项整治前比较差异有统计学意义(P<0.05);同时人均抗菌药物消耗金额以及抗菌药物销售金额占药品总销售金额的比例显著下降,与专项整治前比较差异有统计学意义(P<0.05)。结论:宝鸡地区各级医院经专项整治活动,其抗菌药物临床应用情况较整治前改善明显,三级医院优于二级医院,但部分指标较专项整治活动方案要求仍有较大差距。

OBJECTIVE： To evaluate the effect of special rectification for clinical application of antibiotics in 28 hospitals from Baoji area and provide reference for the continuous promotion of rational use of antibiotics. METHODS： By using retrospec- tive method, the application index of antibiotics was analyzed statistically before and after special rectification in terms of DDDs and consumption sum. RESULTS： After special rectification, the number of antibiotics types in 28 hospitals of Baoji area was all in line with the limit standard; utilization ratio of 80% antibiotics and AUD of 40 % antibiotics in the inpatients were up to the standard in three-level hospitals; utilization ratio of 34.8% and AUD of 21.7% were up to the standard in secondary hospitals; 80% of three-level hospitals and 43.5% of secondary hospitals had ideal proportion of outpatient antibiotics prescriptions. 40% of three-level hospitals had ideal prophylactic use of antibiotics in type I incision surgery; compared with before special rectification, the above index had significant difference （P〈0-05）. The prophylactic use of drugs in type I incision surgery in secondary hospitals was in high level, and delivered rate of microorganism samples in hospitals at all level was all low. The utilization ratio and AUD of antibiotics for special use were significantly reduced in hospitals at all level, and compared with before special rectification, there was significant difference （P〈0-05） ; in addition, the per capita consumption sum of antibiotics and the consumption sum proportion of antibiotics in overall drugs were significantly decreased, and compared with before special rectification, there was signifi- cant difference （P〈0-05）. CONCLUSIONS： Rational use of antibiotics in 28 hospitals from Baoji area have been significantly improved after special rectification for clinical application of antibiotics, and the improvement of three-level hospitals was better than that of secondary hospitals. There still are large gap between some index and special rectification requirements.