北京市60件抗感染药物用药纠纷调解案例分析及防控措施探讨

Sixty cases of dispute mediation of anti-infective drug use in Beijing and discussion on prevention and control measures

目的:较全面了解北京地区抗感染药物用药纠纷现状,促进抗感染药物合理应用,构建有效的用药纠纷防控措施。方法:对北京市医疗纠纷人民调解委员会登记的结案日期在2013年1月至2019年12月的全部抗感染药物用药纠纷资料进行回顾性整理,对60件抗感染药物用药纠纷调解案例的分布特点、药品种类、过失原因等进行多角度分析,探讨纠纷防控措施。结果:抗感染药物用药纠纷大多发生在三级医疗机构(56.7%);患者女性(65.0%)多于男性(35.0%);抗感染药物用药纠纷发生较多的科室排名前四分别是呼吸内科、儿科、急诊科、耳鼻喉科;引发用药纠纷的药品种类主要有头孢菌素类、喹诺酮类、青霉素类、氨基糖苷类等;过失原因主要为超剂量(18.9%)、用药禁忌(17.2%)、无适应证用药(17.2%)、未询问过敏史(10.4%)等。结论:应提高医务人员和患者对抗感染药物用药相关问题的重视,按照有关规范标准合理使用抗感染药物,在各环节建立防控措施,加强抗感染药物处方审核与点评,有效发挥临床药师的专业作用,减少患者用药风险与纠纷的发生。

OBJECTIVE To fully understand the current status of anti-infective medication disputes in Beijing, promote the rational application of anti-infective drugs and establish effective prevention and control measures for medication disputes. METHODS Retrospective reviews were conducted for all anti-infective drug dispute data registered by Beijing Municipal People’s Mediation Committee for Medical Disputes between January 2013 and December 2019.And the distribution characteristics were analyzed for 60 mediation cases of anti-infective drug disputes.The types and causes of negligence were discussed from multiple angles. RESULTS Most disputes over the use of anti-infectives occurred at tertiary medical institutions,(56.7%).There are(65.0%)more female patients than(35.0%)males.The top four departments with more disputes about the use of anti-infective drugs were respiratory medicine, pediatrics, emergency department and otolaryngology.The major types of drugs under disputes were cephalosporins, quinolones, penicillins and aminoglycosides, etc;The major causes of negligence were overdose(18.9%),medication with contraindications(17.2%),medication without indications(17.2%)and no inquiry of allergy history(10.4%),etc.CONCLUSION Medical staff and patients should pay more attention to issues related to the use of anti-infective drugs.Anti-infective drugs should be rationally dosed in accordance with relevant norms and standards.Enhancing the professional role of clinical pharmacists reduces the occurrence of medication risks and disputes among patients.