儿科临床药师参与抗菌药物应用管理的实践

Practice of Paediatric Clinical Pharmacists in the Management of Antimicrobial Drugs

目的:研究儿童医院专科临床药师在抗菌药物临床应用管理中的作用,探讨合适的抗菌药物使用强度计算方法,为临床合理用药提供参考。方法:回顾性分析安徽省儿童医院2017年1—7月(临床药师干预前)、2018年1—7月(临床药师干预后)住院患儿抗菌药物使用情况和合理用药率。结果:抗菌药物使用率由干预前(64.80±4.80)%降至干预后(54.59±4.70)%(P<0.05);按药品消耗量计算,抗菌药物使用强度由干预前(44.04±1.70)降至干预后(32.75±3.30);按实际使用量计算,抗菌药物使用强度由干预前(27.26±2.60)降至干预后(20.93±2.70);住院患儿药物总金额占药品总金额百分比由干预前(23.27±0.80)%降到干预后(21.65±1.50)%;出院患儿人均抗菌药物费用由干预前(856.03±25.70)元降至干预后(767.20±50.20)元(P<0.05);抗菌药物病历点评不合理率持续下降。结论:儿童医院临床药师对抗菌药物应用管理的干预有效,并提出了适合儿童医院抗菌药物使用强度的计算方法。

Objective:To study the role of clinical pharmacists in the management of clinical use of antimicrobial,and to explore a more suitable method for calculating the strength of antimicrobial drugs,so as to provide references for their rational use.Methods:Retrospective analysis of antimicrobial drugs use and rational drugs use rate of inpatients before and after intervention by clinical pharmacists in Anhui Children's Hospital from January to July of 2017 and 2018.Results:The usage rate of carbapenems decreased from(64.80±4.80)%to(54.59±4.70)%(P<0.05).The intensity of consumption decreased from(44.04±1.70)to(32.75±3.30)(P<0.05).The intensity of consumption(counted by actual usage)decreased from(27.26±2.60)to(20.93±2.70)(P<0.05).Total amount of antimicrobial consumption in inpatients as a percentage of total amount of drugs decreased from(23.27±0.80)%to(21.65±1.50)%.Cost of antimicrobial drugs per patient discharged decreased from(856.03±25.70)yuan to(767.20±50.20)yuan.The rate of unreasonable evaluation of antimicrobial drug records continues to decline.Conclusion:Intervention by clinical pharmacists can promote the rational use of antibacterial drug and propose a more suitable method for calculating the use strength of antimicrobial drugs.