开封市11所乡镇卫生院4972张抗生素处方点评分析及安全用药合理化建议

Evaluation and Analysis of 4972 Antibiotic Prescriptions in 11 Township Hospitals in Kaifeng and Suggestions for Rationalizing the safe Use of Antibiotics

目的了解开封市乡镇卫生院抗生素使用情况及存在的问题,为基层安全用药提出合理化建议。方法按比例随机抽取开封市11所乡镇卫生院2019年3月至2019年9月门、急诊抗生素处方4972张,实施逐一审查点评。对抗生素使用情况进行统计,归类总结不规范用药及不合理处方、观察抗生素整体使用情况、前10位抗生素、书写不规范处方、用药不适宜处方情况。结果4972张抗生素处方中,口服抗生素处方所占比例为73.03%(3631/4972),注射用抗生素处方所占比例为25.82%(1284/4972),口服、注射用抗生素联合应用处方所占比例为1.15%(57/4972);单药处方所占比例为92.90%(4619/4972),二联用药处方所占比例为7.10%(353/4972);前10位抗生素主要包括头孢地尼胶囊、头孢呋辛脂片、左氧氟沙星注射液等,所占总处方量比例分别为24.90%(1238/4972)、18.62%(926/4972)、15.51%(771/4972);书写不规范处方597张,占总处方量比例12.01%(597/4972);用药不适宜处方67张,占总处方量比例1.35%(67/4972)。结论开封市乡镇卫生院抗生素整体使用情况良好,针对处方书写不规范、用药不适宜等问题,应在提高医师用药水平基础上,加强药师审方制度,保证安全用药,促使医疗服务水平全面提升。

Objective To understand the situation and problems of antibiotic use in township hospitals in Kaifeng,and to make rational recommendations for safe drug use at the grass-roots level.Methods A total of 4972 prescriptions were randomLy selected from 11 township hospitals in Kaifeng from March 2019 to September 2019,review and comment one by one.The use of antibiotics was statistically analyzed,and the non-standard drug use and irrational prescription were summarized.The overall use of antibiotics,the top 10 antibiotics,writing non-standard prescription and inappropriate prescription were observed.Results Among the 4972 antibiotic prescriptions,73.03%(3631/4972)were oral antibiotics,25.82%(1284/4972)were injectable antibiotics,the proportion of prescriptions for oral and injection antibiotics was 1.15%(57/4972),the proportion of prescriptions for single drug was 92.90%(4619/4972),and the proportion of prescriptions for combined antibiotics was 7.10%(353/4972);The top 10 antibiotics included cefdinir capsules,cefuroxime tablets and levofloxacin injection,which accounted for 24.90%(1238/4972),18.62%(926/4972)and 15.51%(771/4972)of the total prescription,respectively there were 597 irregular prescriptions,accounting for 12.01%(597/4972)of the total prescriptions,and 67 unsuitable prescriptions,accounting for 1.35%(67/4972)of the total prescriptions.Conclusion The overall use of antibiotics in township hospitals in Kaifeng is good.In order to solve the problems of irregular prescription writing and inappropriate drug use,we should strengthen the prescription examination system of pharmacists and ensure safe drug use on the basis of improving the drug use level of doctors,to promote the overall level of medical services.