样本医院儿童用药现状分析

Analysis of the current situation of pediatric drugs use in the sample hospital

目的:调查研究样本医院儿童用药的基本情况以及重点药物的使用情况,分析可能的危险因素。方法:回顾分析样本医院2017年7月至2018年6月门诊及住院患者中1~14岁儿童的用药情况,进行分类、排序、汇总分析,结合说明书,判断其医嘱是否超说明书,并对重点药物进行进一步分析研究。结果:样本医院处方占比最多的药物依次是平喘类药物、头孢菌素以及维生素类药物,处方占比最高的20种药物总权重是72.98%,前20种药物中有19种药物说明书中明确规定了针对儿童的用法用量;注射用盐酸氨溴索有96.31%的患者用药频率为每天一次,100%的6岁以下儿童存在单次用药剂量过大问题,6~12岁患者中有52%的人存在剂量过大问题;阿奇霉素注射剂存在超说明书情况,但基本能做到对症使用,按需给药。结论:样本医院在儿童用药选择方面卓有成效,但在个别重点药物使用上存在超说明书使用现象,需要重点关注,并制定相关措施进行干预和保障。

OBJECTIVE To investigate the basic situation of children's medication and the use of key drugs in the study sample hospital and analyze the possible risk factors.METHODS The medication status of children aged 1-14 years among outpatients and inpatients in the sample hospital from July 2017 to June 2018 was retrospectively analyzed,classified,ranked,and summarized.Combined with the instructions,whether the doctor's advice was off-label was judged,and the key drugs were further analyzed and studied.RESULTS The drugs with the highest proportion of prescriptions in the sample hospitals were anti-asthmatic drugs,cephalosporins and vitamins,and the total proportion of the 20 drugs with the highest proportion of prescriptions was 72.98%.The usage and dosage for children were clearly specified in the package inserts of 19 drugs of the top 20 drugs;96.31%of the patients used ambroxol hydrochloride for injection once a day,100%of the children under 6 years of age had excessive dosage,and 52%of the patients aged 6-12 years had excessive dosage;there was off-label use of ambroxol injection,but it could basically be used symptomatically and administered as needed.CONCLUSION The selection of pediatric drugs was quite effective in the sample hospital,but there is off-label use in the use of individual key drugs,which needs to be paid attention to,and relevant measures should be formulated for intervention and guarantee.