摘要
目的:比较北京市某三甲医院2013年和2017年急诊科抗菌药物处方,分析其临床用药合理性,以期为临床抗菌药物规范管理和使用提供参考。方法:选取北京市某三甲医院急诊科抗菌药物处方2013年20056张和2017年39842张,对医院急诊中抗菌药物的使用类别、基本药物使用情况、给药途径、联合用药等情况进行描述性分析。结果:2013年和2017年不同机理的抗菌药物用药情况出现较大变化,如氨基糖苷类、头孢菌素类药物。基本药物使用率降低,以氨基糖苷类、大环内酯类、第二代头孢菌素类、硝基咪唑类尤为明显。限制使用级抗菌药物占比上升,如头孢地尼、依替米星。抗菌药物总使用量排名前5位的病种中,第一代、第二代头孢菌素类药物使用率降低,第三代使用率增加。抗菌药物注射率上升,以第一代、三代头孢菌素类、大环内酯类药物尤为明显。联合用药比例有所下降,以二联用药、三联及四联用药较为明显。结论:抗菌药物使用管控效果不理想,基本药物使用、注射用药比例以及限制级抗菌药物的使用等方面存在不合理现象,需进一步加强抗菌药物管理。
Objective:To compare antibacterial agents'prescriptions between 2013 and 2017 in the emergency department from a tertiary hospital with level 3 in Beijing,and to analyze the rationality of clinical medication,in order to provide reference for the management and regulation of clinical antibacterial agents use.Methods:20,056 antibiotic prescriptions in 2013 and 39,842 antibiotic prescriptions in 2017 were issued in the emergency department of a tertiary hospital with level 3 in Beijing,with descriptive analysis of antibacterial agents'categories,national essential medicine proportion,routes of administration,and medical combination.Results:Pharmacologically different antibacterial agents showed great changes,such as aminoglycosides and cephalosporins.And the overall use rate of national essential drugs reduced,especially for aminoglycosides,macrolides,second generation cephalosporins,and nitroimidazoles.The proportion of restricted antibiotics showed a significant increase,such as cefdinir,etimicin.Among the ranking five diseases of total antibacterial agents use,the ratio of the first and second generation cephalosporins decreased,and that of the third-generation cephalosporins increased.The overall injection rate of antibacterial agents increased,especially in the first and third generation cephalosporins as well as macrolides.The proportion of combined medications decreased,especially for two-drugs therapy,triple-drugs therapy and quadruple-drugs therapy.Conclusion:The effect of antibacterial agents'control in the emergency department of this hospital is not satisfactory.The phenomena of clinical irrational drug use still exist.Further measures should be taken to strengthen drug management.
作者
廖伏翠
林少武
陈辰
舒彦松
吴久鸿
刘跃华
Liao Fucui(Zhongnan Hospital of Wuhan University,Wuhan,430071)
出处
《医学与社会》
北大核心
2020年第3期37-41,共5页
Medicine and Society
关键词
合理用药
急诊
抗菌药物
处方
Rational Drug Use
Emergency Call
Antibacterial Agents
Prescription