陕西省基层医疗机构门诊抗菌药物使用情况分析

Analysis of the Use of Prescribed Antibacterial in Primary Health Care Facilities in Shaanxi Province

目的:了解陕西省基层医疗机构门诊抗菌药物的使用现状,为指导临床合理使用抗菌药物提供参考。方法:于2013年4至5月,随机抽取陕西省6个地市54家基层医疗机构的门诊处方共4680份,采用回顾性调查方法对抗菌药物使用率、抗菌药物联用率及上呼吸道感染(简称"上感")病症抗菌药物使用情况进行统计分析。结果:4680份处方中,抗菌药物使用率为42.7%;抗菌药物联用率为9.5%;966份"上感"病症处方中大多(60.7%)开具了抗菌药物;不同地域(P=0.001)及不同类别医疗机构(P<0.001)抗菌药物使用情况均存在差异;不同地域(P=0.002)及不同类别医疗机构(P<0.001)抗菌药物联用情况均存在差异;不同类别医疗机构(P<0.001)中,"上感"病症的抗菌药物使用情况也存在差异。结论:陕西省基层医疗机构门诊抗菌药物使用存在不合理现象,应进一步提高抗菌药物合理使用意识,规范医生处方行为,提高临床合理使用抗菌药物水平。

Objective： To identify the current patterns of antibacterial prescribed in primary health care settings of Shaanxi Province, so as to provide references for rational use of antibacterial. Methods： A total of 4680 outpatient prescriptions were randomly selected from 54 primary medical institutions in 6 cities of Shaanxi Province, from April to May in 2013. The rate of antibacterial use only, combined use with antibacterial and antibacterial use for upper respiratory tract infections by outpatients were analyzed as measurements of antibacterial utilization. Results： The percentage of antibacterial prescribed was 42.7%; the utilization rate of combined use was 9.5%, and the proportion of antibacterial use for upper respiratory tract infections was 60.7%. The percentage of antibacterial prescribed was statistically different among different regions（P =0.001） and different types of health care facilities（P〈0.001）; the rate of combined use was statistically different among different regions（P =0.002） and different types of health care facilities（P〈0.001）; the proportion of antibacterial use for upper respiratory tract infections was statistically different among various categories of health care settings（P〈0.001）. Conclusion： There were some problems of antibacterial use in primary health care settings in Shaanxi Province. We suggest that the awareness of rational use of antibacterial should be further enhanced and doctors＇ prescribing behavior should be standardized, so as to improve the level of clinical rational use of antibacterial.