专项整治前中后三阶段某院抗菌药物应用情况的回顾性研究

Retrospect Research on Effect of Using the Strict Antibiotic Rectification at Prophase, Metaphase and Anaphase

目的分析抗菌药物专项整治活动前、中、后三个阶段我院住院患者抗菌药物使用情况,以评价该活动对提高医院抗菌药物合理使用水平的效果。方法采用回顾性调查方法,分别对前期(整治前,2010年1~6月)、中期(整治中,2013年1~6月)及后期(整治后,2015年1~6月)我院抗菌药物使用率、使用强度(AUD)、特殊级抗菌药物使用频度(DDDs)等数据进行统计分析。结果前期的使用率为(70.73±25.11)%,中期为(51.65±28.56)%,后期为(53.32±27.75)%,中后期均较整治前极显著下降(P<0.01);前期使用强度为(67.05±43.80),中期为(45.90±33.52),后期为(53.80±41.49),均较整治前显著下降(P<0.05);Ⅰ类切口手术预防抗菌药物使用率从95.07%最终降至24.82%,同时其使用合理率也从6.71%上升至81.2%(均P<0.01)。特殊级抗菌药物的使用频度也大幅下降(P<0.01)。结论抗菌药物专项整治对于Ⅰ类切口手术预防应用抗菌药物及特殊级抗菌药物的合理使用效果显著,对不合理用药仍需强化管理。

Objective To evaluate the effect of the strict antibiotic rectification by analyzing the rationality of the consume of the antibiotics in our hospital at its prophase, metaphase and anaphase. Methods Subjects were divided into 3 groups： prophase group （before the use of policy, Jan.-Jun.2010）, metaphase group （during the use of policy, Jan.-Jun.2013） and anaphase group（after the use of policy, Jan.-Jun.2015）, the consume rate, the use intensity of antibioties（AUD） and the medication frequency （DDDs）of special class antibiotics were statistic by means of retrospective survey. Results The consume rate of prophase, metaphase and anaphase were （70.73±25.11）%, （51.65±28.56）% and （53.32±27.75）%, respectively, the latter was obviously declined compared with it of prophase（P〈0.01）; the AUD of prophase, metaphase and anaphase were （67.05±43.80）,（45.90±33.52） and （53.80±41.49）, respectively, the latter was also decreased compared with it of prophase（P〈0.05）; the consume rate of antibiotics for prevent purpose in the site of I type operation was decreased from 95.07% to 24.82%, meanwhile the rationality rate was increased from 6.71% to 81.2%（P〈0.01）; the consume rate of special class antibiotics were also obviously declined（P〈0.01）. Conclusion The strict antibiotic rectification was proved have marked contribution to the decline of the consume of the special class antibiotics and its reasonability in I type operation site. More rectification should be kept on. [