医院抗菌药物使用强度的分析与建议

Analysis and suggestions on the use intensity of antibiotics in hospitals

目的 分析医院住院患者2020年第一季度抗菌药物使用强度,为合理使用抗菌药物提供参考依据。方法 选取2020年第一季度由台山市人民医院信息科提供的住院患者(综合病区除外)抗菌药物应用数据资料。分析各科室抗菌药物用药频度(DDDs)和使用强度(AUD),各类抗菌药物DDDs和AUD,用药强度前15位抗菌药物DDDs、AUD及日用药金额(DDC)情况。结果 2020年第一季度住院患者AUD均值为54.46,医院第一季度共设科室25个,有12个科室AUD(48%)高于卫生部要求的40 DDDs,其中ICU、呼吸科和妇科AUD远高于40 DDDs;各类抗菌药物AUD排名首位为第三代头孢菌素类;注射用头孢曲松钠则在用药强度前15位抗菌药物中AUD为7.67,居于首位;盐酸左氧氟沙星氯化钠注射液的AUD为4.52,居于次位。整体来看,抗菌药物种类以头孢类和头孢类+酶抑制剂为主;注射剂型使用强度明显高于口服剂型,口服剂型中使用强度最大的为阿奇霉素(AUD为1.34),居用药强度排名中第15位。结论 针对医院可能存在的抗菌药物用药过度、广谱抗菌药物的使用率高,β-内酰胺类+酶抑制剂类和喹诺酮类药物用量过大等问题,应进一步加强监督管理。

Objective To analyze the use intensity of antibiotics in hospitalized patients in the first quarter of 2020,so as to provide reference basis for rational use of antibiotics. Methods Select the application data of antibiotics in inpatients( except comprehensive wards) provided by the Information Department of Taishan people’ s Hospital in the first quarter of2020. The DDDs and AUD of antibiotics in each department,DDDs and AUD of various antibiotics,DDDs and AUD and DDC of the top 15 antibiotics were analyzed. Results The average aud of inpatients in the first quarter of 2020 was 54. 46.In the first quarter,the hospital set up 25 departments,and the AUD of 12 departments( 48%) was higher than the 40 DDDs required by the Ministry of health,among which the AUD of ICU,respiratory department and gynecology department was much higher than 40 DDDs. The third generation cephalosporins ranked first in AUD of various antibiotics. Ceftriaxone sodium for injection ranked first among the top 15 antibiotics( AUD is 7. 67). The AUD of levofloxacin hydrochloride and sodium chloride injection was 4. 52,ranking second. On the whole,cephalosporins and cephalosporins + enzyme inhibitors are the main types of antibiotics. The use intensity of injection dosage form is significantly higher than that of oral dosage form. Azithromycin( AUD is 1. 34) has the largest use intensity among oral dosage forms,ranking 15th in the drug intensity ranking.Conclusion In view of the problems that may exist in the hospital,such as excessive use of antibiotics,high utilization rate of broad-spectrum antibiotics,β-lactam combined enzyme inhibitors,excessive dosage of quinolones and so on,supervision and management should be further strengthened.