我院门诊处方中抗菌药物不合理使用的分析及点评

Analysis and Comment on Irrational Use of Antibiotics in Outpatient Prescriptions in Our Hospital

目的探讨分析我院门诊处方中抗菌药物的不合理使用情况,并对其不合理使用进行点评,以进一步提高临床用药安全。方法随机抽取2017年1月至2017年12月我院的门诊处方48690张,其中抗菌药物处方7358张,对抗菌药物的不合理使用情况进行分析统计。结果本次抽取的48690张门诊处方中,抗菌药物处方7358张,占抽取处方总数的15.11%,其中使用较多的抗菌药物种类分别为头孢菌素类(31.49%)、青霉素类(23.00%)、喹诺酮类(13.71%)、大环内酯类(11.65%)。7358张抗菌药物处方,处方合格的3579张,另外79张抗菌药物处方存在不合理使用情况,占抗菌药物处方的比例为2.61%。常见的不合理使用类型包括抗菌药物选择不当(24.48%)、用法用量不合理(20.31%)、药物使用指征不明确(14.58%)、联合用药不合理(13.54%)、溶媒选用不当(9.38%)、药物重复使用(6.25%)以及处方书写不规范(11.46%)。结论我院门诊抗菌药物使用中存在一定比例的不合理情况,临床需要加强对抗菌药物使用的监督和管理,严格选择药物的适应证,并避免重复大剂量给药,注意不同药物间的相互作用,从而确保临床使用抗菌药物的合理性和安全性。

Objective To explore the irrational use of antibiotics in outpatient prescriptions in our hospital,and to make comments on their irrational use,so as to further improve the safety of clinical medication.Methods A total of 48690 outpatient prescriptions in our hospital from 2017 to December 2017 01 were randomly selected,including 7358 prescriptions for antimicrobial agents,and the irrational usage of antibiotics was analyzed.Results 48690 outpatient prescriptions in the extraction of antimicrobial prescriptions of 7358,accounting for 15.11% of the total extract prescription,among which the most frequently used antibiotics were cephalosporins and penicillins（31.49%）（23%）（13.71%）,quinolones,macrolides（11.65%）.7358 prescriptions for antimicrobial agents,3579 prescriptions,and 79 prescriptions for antibiotics were unreasonable,accounting for 2.61% of the total prescriptions.The irrational use of common types include the improper selection of antibiotics（24.48%）,irrational usage and dosage,drug use（20.31%） without clear indication（14.58%）,irrational combined medication（13.54%）,inappropriate choice of solvent（9.38%）,repeated use of drugs（6.25%） and（11.46%） does not regulate prescription writing.Conclusion The unreasonable antibiotics in our hospital has a certain proportion in use,strengthen the supervision and management of the use of antibacterial drugs in clinical needs,strict selection of drug indications,and avoid repeated large dose administration,pay attention to the interaction between different drugs,so as to ensure the rationality and safety of clinical use of antibacterial drugs.