住院患者抗菌药物使用的回顾性分析

Retrospective Analysis of Antibacterials Use of Patients in Hospital

目的对住院患者抗菌药物使用情况进行回顾性分析,为合理使用抗菌药物提供参考。方法收集2010年1月至2012年12月我院住院患者抗菌药物使用的原始数据进行分析。评价病原菌分布,革兰阳性球菌、革兰阴性杆菌的耐药率及用药频度,抗菌药物使用强度等。结果住院病历中共记载细菌2 300株,其中革兰阴性杆菌1 575株,占68.47%;革兰阳性球菌640株,占27.83%;真菌85株,占3.70%。革兰阳性球菌的耐药率与DDDs具有高度相关性(R=0.827,P<0.05);革兰阴性杆菌的耐药率与用药频度呈现中等相关性,但无统计学差异(R=0.568,P>0.05)。头孢曲松、红霉素、头孢唑啉抗菌药物使用强度在2010年分别为5.03、7.32、2.33,2011年分别为6.55、4.01、2.41,2012年分别为5.13、3.33、3.01,排名始终位于前5位,抗菌药物使用强度前5位顺序有一定变化,但抗菌药物使用强度值呈逐年下降趋势。结论病原菌对抗菌药物的耐药性越高,用药频度越高,我院抗菌药物的使用情况比较合理,但仍需进一步加强。

Objective The using situation of antibacterials for patients in our hospital was retrospectively analyzed, in order to provide evidence for the rational use of antibacterials.Methods Distribution of pathogens, drug resistance rate and drug frequency （DDDs） of Gram-positive cocci and Gram-negative bacilli, the antibacterials use density （AUD） of patients from 2010 to 2012 in our hospital were retrospectively analyzed.Results 2 300 strains of bacteria were recorded in medical records, with 1 575 strains of Gram-negative bacilli （68.47%）, 640 strains of Gram-positive cocci （27.83%）, 85 strains of fungi （3.70%）. Drug resistant rate of Gram-positive cocci was highly correlated with DDDs （R=0.827,P＆lt;0.05）. Drug resistance rates of Gram-negative bacilli showed moderate correlation with DDDs, but the differences were not signiifcant （R=0.568,P＆gt;0.05）. The AUD of ceftriaxone, erythromycin and cefazolin between 2010~2012 ranked the top ifve consistently （2010：5.03,7.32,2.33;2011：6.55, 4.01,2.41;2012：5.13,3.33,3.01）, the top ifve order of AUD for antibacterials had a few changes, and the AUD values declined in the three years.Conclusion The higher DDDs, the higher antibacterials resistance of pathogens, the antibacterials usage in our hospital was generally reasonable, but the rational use still needs to be further strengthened.