系统抗菌药物干预考核对医院抗菌药物使用强度的影响

Effect of Systematic Antibiotic Intervention Assessment Programs on Antibiotic Use Density

目的：制定系列抗菌药物系统干预考核方案,观察考核方案实施后对抗菌药物使用强度（AUD）的影响。方法：采用前瞻性研究方法,2013年仅对干预组实施系统抗菌药物干预考核方案,对照组不实施;2014年2组统一实施系统抗菌药物干预考核方案,考察2组抗菌药物使用率、使用合理性、微生物送检率、围术期抗菌药物预防性使用率及AUD等。结果：2013年干预组抗菌药物使用率、使用合理性、微生物送检率等与对照组比较差异均具有统计学意义（P〈0.05）;干预组Ⅰ类切口抗菌药物预防性使用率明显低于对照组,24-48 h停药率明显高于对照组。2014年上半年2组均实施方案后对照组各项指标较前明显提高,2组抗菌药物使用率的差异无统计学意义（P〉0.05）。2组Ⅰ类切口抗菌药物预防性使用率、24-48 h停药率等均进一步改善,对照组尤为明显。干预组AUD较对照组下降明显。结论：通过实施系统抗菌药物干预考核方案可有效降低医院AUD。

OBJECTIVE：To develop a series of antibiotic intervention assessment programs and evaluate their effects on the antibiotic use density （ AUD） .METHODS：In this prospective study, antibiotic intervention assessment programs in 2013 were only applied to intervention group but to both intervetion group and the control group in 2014.The outcome measrues were rate of antibitic use, rationality in antibiotic use, microbial inspection rate, rate of corect perioperative use of prophylactic antibiotics and AUD.RESULTS： In 2013, the differences in rate of antibitic use, rationality in antibiotic use, microbial inspection rate between the intervention group and the control group were significantly significant （ P〈0.05）;the rate of antibiotic use in patients undergoing type I incision operation was significantly lower and the rate of patients with antibiotic withdrawal within 24-48 hours was significantly higher in the intervention group than in the control group.In the first half of 2014 （ after implementing intervention programs in two groups ） , the antibiotic use indexes in the control group improved significantly as comapred with before intervention, and the difference between the intervention group and the control group in rate of antibitic use were not significant （P 〉0.05）.The rate of antibitic use and the rate of patients with antibiotic withdrawal within 24-48 hours in both groups improved significantly, much as in the control group.The AUD in the intervention group declined more significantly than in the control group. CONCLUSIONS：The antibiotic intervention assessment programs can efffectively reduce the AUD.