合肥市第二人民医院门急诊抗菌药物处方分析点评

Analysis and Evaluation on Antibiotic Prescriptions in Outpatients and Emergency Departments in the Second People's Hospital of Hefei

目的:了解合肥市第二人民医院门急诊抗菌药物应用现状及存在问题,探讨抗菌药物合理应用的管控措施。方法:随机抽取2014年1-5月的门急诊抗菌药物处方2166张,对抗菌药物的使用情况进行统计分析,针对存在的问题进行整改。结果:2166张抗菌药物处方中,单用处方2051张,占94.69%,联用处方115张,占5.31%;口服剂型处方1956张,占90.32%,注射剂型处方190张,占8.77%。急诊科、儿科和呼吸内科抗菌药物应用比例较高,共占60.00%。抗菌药物处方中头孢菌素类使用频次居首位(73.29%),且品种最多,大环内酯类(9.25%)和硝基咪唑类(5.66%)分别居第2、3位;不合理处方有457张,占21.10%,主要问题是应用指征不明确、选药不适宜和越级用药,分别占不合理处方的52.30%、21.44%、14.44%。结论:门急诊抗菌药物处方存在不少问题,应加强技术干预和行政处罚力度,针对临床医师、药师加强抗菌药物合理应用的管理和培训,以确保抗菌药物安全、有效、经济地应用。

Objective： To be informed of the current situation and problems in application of antibiotic agents in the departments of outpatients and emergency in The Second People＇s Hospital of Hefei, so as to explore regulations and control measures of rational use of antibiotic agents. Methods： Totally 2166 antibiotic prescriptions in the departments of outpatients and emergency department from January to May in 2014 were randomly selected. The utilization of antibiotics was analyzed statistically, and the suggestions were provided for the existing problems. Results： Among the 2166 prescriptions, there were 2051 ones of single medication, accounting for 94.69%; 115 ones of combined medication, accounting for 5.31%; 1956 oral dosage prescriptions, accounting for 90.32%; and 190 injectable dosage prescriptions, accounting for 8.77%. The proportion of antibiotic application was high in the departments of emergency, pediatrics and respiratory medicine, totally accounting for 60.00%. The frequency of cephalosporins（73.29%） was the highest among all the prescribed antibiotics, and the varieties of these antibiotics were the most. Macrolides（9.25%） and nitroimidazoles（5.66%） ranked the second and the third place. There were 457 unreasonable antibiotic prescriptions, accounting for 21.10%. The main problems in these prescriptions were unclearness of indications, inappropriate drug selection and leapfrog medication, respectively accounting for 52.30%, 21.44%, and 14.44% among all unreasonable prescriptions. Conclusion： There are still many problems in antibiotic prescriptions in outpatients and emergency departments. Rational use of antibiotics should be strengthened by means of technical interventions, administrative penalties, as well as antibiotic management and training for clinicians and pharmacists, so as to ensure that medicines are used safely, effectively and economically for patients.