干预前后建德地区17家基层卫生院门、急诊抗菌药物应用合理性分析

Analysis on Application of Antibacterial Drugs in Outpatient and Emergency Department of 17 Primary Health Centers in Jiande Before and After Intervention

目的:探讨干预措施对基层卫生院门、急诊抗菌药物使用的影响,为基层卫生院合理使用抗菌药物和规范管理提供参考。方法:选择建德地区17家基层卫生院2015年6月门、急诊抗菌药物处方各100张(共1 700张)设为干预前组,2015年10月门、急诊抗菌药物处方各100张(共1 700张)设为干预后组,对基层卫生院门、急诊抗菌药物应用情况进行回顾性分析。结果:干预前后,抗菌药物使用品种无变化,处方数构成比排序居前6位的抗菌药物分别为头孢菌素类、青霉素类、克林霉素类、氟喹诺酮类、头霉素类和硝基咪唑类;与干预前比较,干预后注射用抗菌药物的使用率明显降低,二联、三联用药处方明显减少,不合理处方明显减少,差异均有统计学意义(P<0.05)。结论:对建德地区17家基层卫生院门、急诊抗菌药物应用情况进行干预,提高了医院合理用药水平,促进了临床合理用药。

OBJECTIVE：To probe into effects of interventions on application of antibacterial drugs in outpatient and emergency department of primary health centers, and provide scientific references for rational application and standard administration of antibacterial drugs. METHODS ： 100 outpatient and emergency prescriptions of antibacterial drugs each health center （17 health centers and 1 700 prescriptions in total） in Jun. 2015 were extracted and set as pre-intervention group, and other 1 700 prescriptions in Oct. 2015 were set as post-intervention group. The application of antibacterial drugs was retrospectively analyzed. RESULTS： There were no changes in the types of antibacterial drugs before and after intervention, the top 6 antibacterial drugs applied were respectively cephalosporins, penicillins, clindamycin, fluoroquinolone, cephamycins and nitroimidazoles. The application rate of antibacterial drugs for injection was significantly decreased after intervention, the numbers of bigeminy prescriptions, trigeminy prescriptions and irrational prescriptions were decreased as well, with statistically significant difference （P 〈 0.05 ）. CONCLUSIONS： The situation of rational drug application was improved after the intervention on the application of antibacterial drugs in outpatient and emergency department of 17 primary health centers in Jiande, which contributed to relieving economic burdens for patients and improving rational drug application.