干预前后特殊使用级抗菌药物应用探讨

Study on Application of Special Use Antibacterial Drugs before and after Intervention

目的特殊使用级抗菌药物实施针对性干预措施后的效果进行研究,并探索抗菌药物分级管理的对策。方法方便抽取该院2015年1—12月期间68例病例进行回顾性分析,调取其在干预前和2次干预后使用特殊使用级抗菌药物后的结果,对处方权限进行统计、分析,并将结果详细记录在特殊使用级抗菌药物审批表中,另外,对68例病例是否进行过微生物送检进行统计,随后,对干预前和2次干预后患者应用特殊使用级抗菌药物的用药频度进行分析。结果第2次干预后应用审批表的填写率为100.00%,第1次干预后应用审批表的填写率上升了16.04%,与干预前比较差异有统计学意义(P<0.05),第二次微生物送检率(83.33%)、处方医师权限合格率(75.00%)明显高于第1次干预后(36.36%、11.76%)与干预前(27.27%、26.47%),差异有统计学意义(P<0.05);两次干预后特殊使用级抗菌药物的用药频度与干预前相比均得到了明显降低,其中头孢吡肟与替加环素的百分比在60%以上。结论特殊使用级抗菌药物的临床应用效果较为明显,能够有效提高抗菌药物合理使用率,且在减少细菌耐药方面存在明显,值得临床应用推广。

Objective To research the effect of targeted intervention measures for special use antibacterial drugs and study the strategies of classification management of antibacterial drugs. Methods 68 cases in our hospital from January to December 2015 were conveniently reviewed, and the results of special use antibacterial drugs before intervention and after intervention of two times were extracted and the prescription limitation was counted and analyzed, and the results were recorded in the approval form, besides, whether the 68 cases were with the microbiology submission was counted, and then the medication frequency of special use antibacterial drugs before intervention and after intervention of two times was analyzed. Results The filling rate of approval form after the second intervention was 100.00%, and the filling rate of approval rate after the first intervention increased by 16.04%, and the difference was statistically significant compared with that before intervention（P〈0.05）, and the submission rate of second microbiology and qualified rate of prescription physicians were obviously higher than those after the first intervention and before intervention, and the differences were statistically significant,[83.33%, 75.00% vs 36.36%, 11.76% vs 27.27%, 26.47%], and the differences were statistically significant（P〈0.05）, and the medication frequency of special use antibacterial drugs after the second intervention obviously decreased compared with that before intervention, and the ratio of cefepime and prostacyclin was more than 60%. Conclusion The clinical application effect of special use antibacterial drugs is obvious, which can effectively improve the rational use rate of antibacterial drugs and reduce the drug tolerance of bacteria, and it is worth clinical application and promotion.