上海市某三级甲等妇产科专科医院2013-2015年抗菌药物类基本药物使用分析

Analysis of the Utilization of Antibiotic Essential Medicines in a Third Grade Class A Maternity Hospital in Shanghai from 2013 to 2015

目的:为促进抗菌药物类基本药物在妇产科专科医院的合理使用提供参考。方法:利用医院信息系统(HIS),收集上海市某三级甲等妇产科专科医院2013-2015年抗菌药物使用的相关数据,重点对其中基本药物的使用情况进行统计和分析。结果:2013-2015年该院抗菌药物使用金额呈下降趋势,而基本药物使用金额占比逐年升高。3年间大环内酯类药物使用金额均排在首位,且其中基本药物使用金额也是最高的;头霉素类(均为非基本药物)使用金额及排序均呈下降趋势;硝基咪唑类药物使用金额排序虽比较靠前,但其中基本药物使用金额占比仍较低。3年间使用金额和用药频度(DDDs)排序前10位抗菌药物品种多数为基本药物,总体用药趋势良好,但基本药物地红霉素肠溶胶囊在同类药品中价格相对较高,使用金额与DDDs排序比<1,经济效益大于社会效益;非基本药物奥硝唑氯化钠注射液使用金额明显高于同类基本药物甲硝唑氯化钠注射液,且排序靠前。结论:抗菌药物类基本药物在该院使用整体状况良好,但个别品种和类别临床使用仍存在一些问题,有待进一步加强管理。

OBJECTIVE： To provide reference for promoting the rational use of antibiotic essential medicines in maternity hos- pitals. METHODS： Using hospital information system （HIS）, relevant data of using antibiotics in a third grade class A maternity hospital in Shanghai from 2013 to 2015 was collected, and the use of its essential medicines was analyzed. RESULTS： The con- sumption sum of antibiotics was on the decrease from 2013 to 2015, while the essential medicine rose year by year. The consump- tion sum of macrolides and essential drugs ranked the first; cephamycins （non-essential medicines） showed downward trend in con- sumption sum; though the consumption sum of nitroimidazole ranked relatively front, its essential medicines accounted for low pro- portion. Most of top 10 antibiotics in term of consumption sum and DDDs were essential medicines within 3 years, showing a good trend, while the price of Erythromycin enteric capsule, an essential drug, was relatively higher in the similar drugs, consumption sum and DDDs ranking ratio was lower than 1, which showed a good economic benefit but not social benefit; while the consump- tion sum of Ornidazole sodium chloride injection, a non-essential medicine, was obviously higher than Metronidazole sodium chloride injection, an essential medicine, showing front ranking. CONCLUSIONS： The utilization of antibiotic essential medicines is generally good, while there are still some problems in the priority and rational use of individual species in the clinic, which need further strengthened management.