2013—2014年河北北方学院附属第一医院住院抗菌药物处方的不合理用药分析

Analysis on unreasonable antibiotic prescriptions in Inpatient Department of The First Affiliated Hospital of Hebei North University from 2013 to 2014

目的调查2013—2014年河北北方学院附属第一医院住院抗菌药物处方不合理用药的情况,为促进临床合理应用抗菌药物提供依据。方法抽取2013年1月—2014年12月河北北方学院附属第一医院住院抗菌药物处方20 000张,对不合理用药情况进行回顾性分析。结果抗菌药物处方存在不合理用药问题的共1 623张,占8.12%;其中存在的问题主要为溶媒种类的选择及溶媒量不当、给药剂量及给药频次不合理、疗程过长或偏短、联合用药指征不明确等;联合用抗菌药物品种数越多,不合理用药的发生率越高;头孢类和青霉素类使用率均较高,不合理用药处方率分别为7.50%、6.19%;而使用率均较低的碳青霉烯类、头霉素类以及抗真菌药处方中不合理用药处方率较高,分别为19.16%、18.36、19.17%。结论河北北方学院附属第一医院住院患者抗菌药物使用基本合理,但仍存在一些问题,需进一步加强临床医师合理应用抗菌药物的相关培训,并加大处方点评力度。

Objective To investigate the unreasonable antibiotic prescriptions in Inpatient Department of The First Affiliated Hospital of Hebei North University from 2013 to 2014, in order to provide a basis for promoting the clinical rational use of antibiotics. Methods By extracting 20000 inpatient antibiotic prescriptions in The First Affiliated Hospital of Hebei North University from 2013 to 2014, the conditions of unreasonable use of antibiotics were recorded and investigated. Results There were 1623 unreasonable antibiotic prescriptions which accounted for 8.12% of the samples. The main types of unreasonable medicine were improper choice of solvent, improper solvent amount, unreasonable dosage and frequency of drug administration, too long or short treatment, and unclear combination therapy indications. And the more the number of combined drugs, the higher the rate of unreasonable antibiotic prescriptions was. Cephalosporins and penicillins were used more often, but unreasonable prescription rates were 7.50% and 6.19%. while the unreasonable prescription rates of using carbapenem, cephamycin and antifungal antibiotics were relatively higher, which were 19.16%, 18.36%, and 19.17%, respectively. Conclusion The using of antibiotics in The First Affiliated Hospital of Hebei North University is basically rational, but there are still some problems, which need strengthening the training for clinicians to reasonable use of antibiotics, and strengthening prescription comment.