住院病历抗菌药物医嘱点评效果分析

Effect Analysis of Antimicrobial Prescription Review on Medical Records

目的评价住院病历抗菌药物医嘱点评效果，改进点评工作。方法对2014年10月～2015年4月医院住院患者抗菌药物使用率、联用率、使用强度、治疗性使用抗菌药物病原微生物送检率、各科室使用强度、不同分代头孢类使用强度构成情况进行统计分析。结果抗菌药物使用率由61．48％降为57．82％，下降比率5．95％，联用率由42．81％降为35．52％，下降比率17．03％，使用强度由55．23DDDs降为50．84DDDs，下降比率7．95％，治疗性使用微生物样本送检率由28．41％提升为38．80％，升高比率36．57％，一、二代头孢使用强度占头孢使用总强度比例由2．54％升高至30．75％，三、四代头孢使用强度占头孢使用总强度比例由97．46％下降至69．25％。按科室统计，全院22个临床科室中15个科室抗菌药物使用强度有不同程度下降，7个科室有上升。结论住院病历抗菌药物医嘱点评促进了抗菌药物合理使用，点评收到较好效果。

Objective To evaluate the effect of antimicrobial prescription by review on medical records and improve comment methods. Methods The percentage of antimicrobial use, combined use rate, antimicrobial use density （AUD）, pathogenic test rate on therapeutic use antimicrobial, AUD of each clinical department and AUD constituent ratios of different generation cephalosporinsins from October 2014 to April 2015 were analyzed. Results The usage percentage, combined use rate and AUD of antimicrobial decreased from 61.48%, 42.81% and 55.23 DDDs to 57.82%, 35.52% and 50.84 DDDs, respectively. Fall ratio is 5.95%,17.03% and 7.95% in turn. Pathogenic test rate on therapeutic medication increased from 28.41% to 38.80%, rise ratio is 36.57%. AUD constituent ratios of the first and second generation cephalosporins increased from 2.54% to 30.75%.Statistics by department, 15 of 22 clinical departments have different decline of AUD. Conclusion Antimicrobial prescription review on medical records has received good results for promoting rational use of antimicrobial in our hospital.