急性上呼吸道感染使用抗生素的处方调查

Prescriptions survey on acute upper respiratory infection treated by antibiotics

目的调查急性上呼吸道感染患者在治疗中抗生素的使用情况。方法回顾性分析2012年1月~2014年12月门诊开具治疗急性上呼吸道感染的处方,随机抽取其中包含抗生素的处方,对其抗生素的使用情况进行分析。结果本研究调查的门诊开具治疗急性上呼吸道感染的抗生素处方中,共计63 694张,其中含抗生素类药物处方9997张,占全部处方的15.70%。用药合理2765例（27.66%）,基本合理5005例（50.06%）,不合理2227例（22.28%）。2227例抗生素应用不合理处方中超说明书剂量使用164张（7.36%）,用法用量不符说明书规定248张（11.14%）,给药频次不恰当206张（9.25%）,单次剂量过大305张（13.70%）,重复给药92张（4.13%）,诊断不明确333张（14.95%）,应用无指征524张（23.53%）,大处方99张（4.45%）,给药途径不恰当121张（5.43%）,超适应证使用42张（1.86%）,药物相互作用6张（0.27%）,剂量缺失83张（3.73%）,禁忌证4张（0.18%）;2种抗生素药物应用明显低于应用1种抗生素药物数量,差异有统计学意义（P〈0.01）;抗生素药物与抗病毒药物联用处方数明显高于抗生素药物与糖皮质激素药物联用处方数,差异有统计学意义（P〈0.01）。结论本院门诊治疗急性上呼吸道感染患者过程中依然存在抗生素滥用的问题,规范化管理有待加强。

Objective To investigate the use of antibiotics in the treatment of patients with acute upper respiratory tract infection. Methods From January 2012 to December 2014,prescriptions for acute upper respiratory tract infection in outpatient clinic were retrospectively and among them,prescriptions with use of antibiotics were randomly selected.The use of antibiotics was analyzed. Results There were 63 694 prescriptions on treating acute upper respiratory tract infection from January 2012 to December 2014 in clinic in the investigation.Among them,9997 prescriptions with use of antibiotics were selected accounting for 15.70%.With regard to medication reasonability,the number of rationality,basic rationality,and irrationality was 2765 cases（27.66%）,5005 cases（50.06%）,and 2227 cases（22.28%） respectively.Among2227 irrational use of antibiotics,overdose stipulated by specification in 164 prescriptions（7.36%）,usage and dosage being inconsistent with specification in 248 prescriptions（11.14%）,inappropriate frequency of administration in 206 prescriptions（9.25%）,single overdose in 305 prescriptions（13.70%）,repeated administration 92 prescriptions（4.13%）,undefined diagnosis in 333 prescriptions（14.95%）,no indication of application in 524 prescriptions（23.53%）,excessive drugs in 99 prescriptions（4.45%）,inappropriate administration route in 121 prescriptions（5.43%）,off-label drug use 42prescriptions（1.86%）,drug interactions in 6 prescriptions（0.27%）,lack of dose in 83 prescriptions（3.73%）,and contraindication in 4 prescriptions（0.18%）.The number of use of two kinds of antibiotics was greatly less than that by single antibiotic with a statistical difference（P0.01）.The number of prescriptions in antibiotics combining with antiviral drugs was much higher than that by antibiotics combining with corticosteroids,which displayed a statistical difference（P0.01）. Conclusion There is still antibiotics abused in the treatment of acute upper respiratory tract infection in outpatient clinics,and standardized management needs to be strengthened.