本所皮肤病门诊抗菌药物处方用药情况分析

The Analysis of the Prescription of Antibiotics in the Dermatology Clinic and the Study of Rational Drug Use

目的分析本所皮肤病门诊抗菌药物处方用药情况,以期能将抗菌药物临床合理用药水平提高.方法采用回顾性调查方式,对江苏沛县疾病预防控制中心皮肤病防治所2018年全年皮肤病门诊抗菌药物处方共9860张进行调查分析,与检验科药敏培养结果相结合,分析本所皮肤病门诊抗菌药物处方应用情况.结果9860张处方中,其中有2230张处方应用了抗菌药物,抗菌药物应用率为22.62%,对抗菌药物应用处方的联合用药情况进行分析可知,7970张处方为单独用药,占80.87%,1740张处方为二联用药,占17.65%,150张处方为三联用药,占1.49%.2230张抗菌药物处方中,2010张为合理用药处方,占90.00%,还有210张处方为不合理用药处方,占10.00%;共培养病原菌610例,其中130例培养结果为阳性,病原菌阳性率为21.57%,药敏培养共520例,药敏培养率为85.87%;病原菌临检例数共2690例,其中有1130例为阳性,阳性率为41.99%,其中真菌占临检阳性例数2290例,阳性率为85.15%;抗菌药物处方2230张,根据病原菌检查结果用药处方共1180张,占52.99%,依据药敏检查结果用药处方共120张,占5.27%;我所皮肤病门诊抗菌药物处方不合理用药情况包括预防用药不合理(4.76%)、潜在药物相互作用(9.52%)、增加不良反应(9.52%)、药理作用拮抗(14.29%)、重复用药(14.29%)、用药指征不明(23.81%)、用法用量不合理(23.81%).结论本所皮肤病门诊抗菌药物处方用药基本合理,但也有部分不合理用药情况存在,主要表现为不合理联用、药敏培养率低等.

Objective To analyze the use of antibiotics prescription in dermatology clinic of our institute,in order to improve the level of rational use of antibiotics.Methods Retrospective investigation was conducted to investigate and analyze a total of 986 antimicrobial prescriptions in the dermatology outpatient department of peixian center for disease control and prevention in jiangsu province in 2018,and the application of antimicrobial prescriptions in the dermatology outpatient department was analyzed by combining with the results of drug sensitivity cultivation in the laboratory department.Results Among the 9860 prescriptions,223 prescriptions were used with antibiotics,the application rate of which was 22.62%;797 prescriptions were used alone,accounting for 80.87%;174 prescriptions were used in combination,accounting for 17.65%;15 prescriptions were used in combination,accounting for 1.49%;201 prescriptions were rational,accounting for 90.00%;21 prescriptions were unreasonable,accounting for 10.00%;61 cases of pathogenic bacteria were cultured,of which 13 cases were positive,the positive rate of pathogenic bacteria was 21.57%,the drug sensitive culture was 52 cases,the drug sensitive culture rate was 85.87%;269 cases of pathogenic bacteria were clinically examined,113 cases were positive,the positive rate was 41.99%,of which 229 cases were fungi,the positive rate was 85.15%;223 prescriptions of antibacterial drugs were used according to the results of pathogenic bacteria examination There were 118 prescriptions(52.99%)and 12 prescriptions(5.27%)according to the results of drug sensitivity test.The irrational use of antibiotics in dermatology clinic of our institute included irrational use of prophylactic drugs(4.76%),potential drug interaction(9.52%),increased adverse reactions(9.52%),pharmacological antagonism(14.29%),repeated use(14.29%)and unclear indications(23.81%)The dosage was unreasonable(23.81%).Conclusion the prescription of antibiotics in our dermatology clinic is basically reasonable,but there are also some unreasonable drug use,mainly manifested as unreasonable combination,low drug sensitivity culture rate.