2014年抗菌药物住院处方点评回顾性分析

Retrospective Analysis of the Prescription Comment of Inpatient Use of Antibiotics in 2014

目的:统计我院住院患者抗菌药物的使用情况,分析不合理用药的表现及原因,促进我院抗菌药物的合理使用,为加强药品的安全监测、指导临床合理用药提供参考。方法:随机抽取我院2014年住院处方1699份,对其中抗菌药物的使用情况进行统计,分析不合理用药现象,研究处方点评干预前后不合理用药的变化。结果:全年共点评1260份清洁手术病例,其中使用抗菌药物病例303份,包括不合理用药病例287份,不合理用药率为94.71%;主要存在的问题为用药时间长、无指征用药及预防用药品种选择不合理。Ⅰ类切口病例中含不合理病例271份,不合理率为28.11%,其中无适应症用药情况最为明显,无适应症用药比例为7.39%。限制级抗菌药物头孢哌酮舒巴坦及特殊级抗菌药物万古霉素不合理应用严重。通过定期专项点评抗菌药物处方并积极落实整改措施,以上不合理应用现象均有明显好转。结论:我院抗菌药物的使用情况不合理使用情况有改善,但仍存在抗菌药物使用不合理情况,需加大力度宣传抗菌药物的合理应用,以确保患者用药安全、有效合理。

Objective： To investigate the usage of antibacterials in our hospital, analyze the reasons and manifestations of irrational drug use, promote the rational use of antibiotics, and provide references for the rational drug use and safety evaluation in clinic. Methods： 1699 inpatient prescriptions were randomly selected from 2014 for hospital prescription comment. The utilization of antibiotics was analyzed statistically, and the suggestions were provided the existing problems. Further the changes before and after reviews prescription intervention were compared. Results： 303 antibiotic prescriptions were evaluated in our hospital in 2014, including 287 irrational use of antimicrobial drugs, the rate of irrational drug use was 94.71%. The main problems were the long time application of medication, no indication use and prevention use of drug varieties unreasonable choiced. Class I incision cases including 271 irrational cases, the unreasonable rate was 28.11%, of which the most obvious error was no indication use, the ratio was about 7.39%. Restricted antimicrobials cefoperazone sulbactam and special class of antibiotics vancomycin existed unreasonable application significantly. Through special comments on antibacterial drugs prescriptions regularly and actively implement corrective measures, the results were significantly improved. Conclusions： The use of antibiotics was rational basically in outpatient prescription, but more work must be done to ensure that medicines were used safely, effectively and economically in patients.