呼吸内科抗菌药物使用强度及药物经济学分析

Analysis of Antibiotic Use Intensity and Pharmacoeconomics in Respiratory Medicine

目的了解我院呼吸内科抗菌药物的使用强度情况,并进行药物经济学分析评估,为合理应用抗菌药物提供参考依据。方法回顾性分析我院2012-06~2014-06间呼吸内科328例患者的临床资料与记录,统计我院呼吸内科抗菌药物的用药频度（DDDs）、抗菌药物使用强度（AUD）,采用线性回归分析抗菌药物的使用强度与细菌的耐药性的关系,运用药物经济学方法进行抗菌药物限定日费用（DDDc）与药物利用指数（DUI）评价。结果我院呼吸内科抗菌药物的使用强度平均为108.6 DDD/100人/d;排名前10位抗菌药物的DDDs与耐药率的相关系数r=0.657,P〈0.05;头孢类抗菌药物日费用较高,DUI〈1;左氧氟沙星、阿莫西林、哌拉西林/舒巴坦等抗菌药物日费用较低,DUI〉1。结论我院呼吸内科抗菌药物的使用强度过高,应严格按照《抗菌药物临床应用指导原则》科学、有计划地分批、分期替换合理应用,以降低细菌耐药性;在此基础上,选用廉价、有效的抗菌药物,以缓解患者就医经济负担。

Objective To evaluate the antibiotic use intensity and pharmacoeconomics in respiratory medicine in the hospital and to provide a guideline for rational antibiotics use. Methods Totally 328 patients who discharged from the respiratory medicine department from June,2012 to June,2014 were enrolled in the study. Defined daily doses（ DDDs）,antibiotic use density（ AUD） and drug utilization index（ DUI） were recorded. The correlation between AUD and bacterial resistance was evaluated by linear regression analysis. DDDs and DUI were evaluated by pharmacoeconomics. Results The daily AUD was 108. 6 DDD per 100 persons. The correlation coefficient of the top 10 DDDs and bacterial resistance was r = 0. 657,P〈0. 05. The cephalosporin was relatively high in daily cost,DUI〈1. However,levofloxacin,amoxicillin,piperacillin / sulbactam were relatively low in daily cost,DUI〉1. Conclusion AUD is over the use strength in the Department of Respiratory Medicine in the hospital,so it should be applied rationally,and be divided scientifically and designedly according to＂Antibiotics Clinical Application Guidance Principle＂. Based on this,cheap and effective antibiotics can remit the cost burden of patients.