济宁市某医院骨科住院患者抗菌药物使用情况调查

Survey on the use of antibiotics among orthopedic hospitalized patients in a hospital of Jining city

目的了解济宁市某院骨科住院患者2014年第二、四季度抗菌药物使用情况及临床分离菌对常用抗菌药物的耐药情况,为骨科临床合理用药提供参考。方法收集济宁市某医院药房2014年第二、四季度骨科抗菌药物使用量和用药频度(DDDs)以及来自检验科分离的有关骨科住院患者感染的致病菌种类和构成比,利用药敏实验对代表性致病菌进行耐药性分析。结果 2014年第四季度骨科住院患者抗菌药物使用率为22.79%,较第二季度(32.81%)有所下降,第四季度抗菌药物使用频度[(DDDs)]为209.81,较第二季度(256.73)有所下降。2014年第二、第四季度分别分离出56株、43株致病细菌,革兰阳性菌有金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌和奇异变形菌等,革兰阴性菌有铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌和鲍曼不动杆菌等。表皮葡萄球菌对各类抗菌药物的耐药性与铜绿假单胞菌对各类抗菌药物的耐药性之间的差异较大。结论某院骨科住院患者的抗菌药物使用情况得到了明显的控制。

Objective To understand the use of antibiotics among the orthopedics inpatients in a hospital of Jining city in the second and fourth quarters of 2014 and the drug resistance of clinical antibiotics,so as to provide reference for the rational clinical use of drugs. Methods Data were collected on the use of antibiotics and DDDs in a pharmacy of a hospital of Jining city in the second and fourth quarters of 2014, pathogenic bacteria species and constituent ratio of the orthopedics inpatients to conduct analysis on the drug resistance of representative pathogenic bacteria with the susceptibility test. Results The usage rate of antibiotics was 22.79% in the fourth quarter of 2014,lower than that of the second quarter （32.81%）. The DDDs of antibiotics was 209.81 in the fourth quarter,lower than that of the second quarter （256.73）. 56 strains and 43 pathogenic bacteria were isolated in second and the fourth quarter respectively, the gram-positive bacteria were staphylococcus aureus, staphylococcus epidermidis, staphylococcus haemolyticus, and Proteus mirabilis. The gram- negative bacteria were Pseudornonas aeruginosa , Escherichia coli , Klebsiella pneumoniae , and Baumanii. The drug resistance of staphylococcus epidermidis was larger than the drug resistance of Pseudomonas aeruginosa. Conclusion The use of antibiotics has been significantly controlled among the orthopedics inpatients in a hospital of Jining city.