重症监护室抗菌药物使用分析及合理化建议

Antibiotic prescription and rationalization proposals in a general intensive care unit

目的评估ICU抗菌药物使用情况，提出有效干预措施，进一步优化抗菌药物治疗。方法对2014年7—9月ICU抗菌药物使用情况和细菌耐药情况进行总结分析。结果所调查的246例患者中，使用抗菌药物225例，抗菌药物使用率为91．46％，其中头孢哌酮舒巴坦和哌拉西林他唑巴坦使用频度最高；送检677例细菌学标本，细菌培养阳性结果98例，送检阳性率为14．47％，分离出病原菌101株。结论医院ICU抗菌药物的使用基本合理，但仍存在使用率偏高，抗菌药物选用级别过高，给药方案缺乏针对性等问题，应切实采取有效干预措施，减少细菌耐药和无效的抗感染治疗。

Objective To assess antibiotic prescription habits, cost pattern and the prospective intervention in Intensive Care Unit was analyzed. Methods Data on antibiotic utilization and antibiotics susceptibility were collected prospectively from individual electronic charts from July 2014 to September 2014. Results 225 of 246 patients surveyed used antimicrobial during the ICU stay, and antibacterial drug utilization rate was 91.46%. Cefperazone - sulbactam and piperacillin - tazobactam were the most prescribed medications. Total defined daily dose （DDDs） was 1121.1 DDDs. Bacteria culture was 98 positive in 677 cases and 101 pathogenic bacteria were isolated. Conclusion Interventional programs should focus on promoting infectious control with rational antibiotic prescription aimed at mini- mizing the future emergence of bacterial resistance and futile.