某院门诊抗幽门螺杆菌处方分析

Analysis of prescriptions of against helicobacter pylori in outpatient department of a hospital

目的 调查、分析常熟市中医院门诊抗幽门螺杆菌(Hp)处方,以期提高临床合理用药。方法 利用医院信息系统(HIS)抽取常熟市中医院门诊2020年6月-2021年6月开具的抗Hp处方900张,涉及900例患者。记录处方中患者的性别、年龄及处方科室分布、给药方案、抗Hp治疗药物,参考指南分析处方的合理性及不合理原因。结果 900张处方中,主要源于消化内科,为752张(占83.56%);均使用2种抗菌药物,铋剂四联方案使用率为100.00%,其中以质子泵抑制剂(PPI)+铋剂+多西环素+阿莫西林使用率最高,占44.00%;其次为PPI+铋剂+多西环素+阿莫西林克拉维酸钾方案、PPI+铋剂+阿莫西林+克拉霉素缓释片方案,分别占26.00%、22.22%。此外,处方中的给药疗程多为10~14 d,占95.56%,基本合理;PPI中泮托拉唑使用率最高,占68.11%;铋剂均使用枸橼酸铋钾;抗菌药物中多西环素使用率最高,占70.00%。在900张处方中,不合理处方127张,占比14.11%,不合理问题主要为用法用量不合理和疗程不合理,无给药方案不合理处方。结论 本院门诊抗Hp药物使用基本合理,但在疗程、药品选择等方面仍有待进一步完善。

Objective To investigate and analyze the prescriptions of against helicobacter pylori( Hp) in the Outpatient Department of Changshu Hospital of Traditional Chinese Medicine,so as to promote clinical rational use of drugs.Methods Using the HIS system,we collected 900 anti-Hp prescriptions in the the Outpatient Department of Changshu Hospital of Traditional Chinese Medicine from June 2020 to June 2021,from 900 patients. Recorded the gender,age,department distribution,drug administration plan and anti-Hp drugs in the prescription,refered to the guide to analyse the rationality and unreasonable reasons of the prescription. Results In 900 prescriptions,752 prescriptions( 83. 56%) originated from the Department of Gastroenterology. Two kinds of antibacterial drugs were used,and the utilization rate of bismuth quadruple scheme was 100. 00%,among them,proton pump inhibitor( PPI) + bismuth + doxycycline + amoxicillin had the highest utilization rate,accounting for 44. 00%;secondly,PPI + bismuth + doxycycline + amoxicillin potassium clavulanate and PPI +bismuth + amoxicillin + clarithromycin sustained-release tablets,accounting for 26. 00% and 22. 22%,respectively. In addition,the course of administration in the prescriptions were mostly 10-14 days,accounting for 95. 56%,which was basically reasonable;the pantoprazole in PPI has the highest utilization rate,accounting for 68. 11%;bismuth potassium citrate was used as bismuth agent;doxycycline in antibiotic had the highest utilization rate,accounting for 70. 00%. Among the900 prescriptions,127 prescriptions were irrational,accounting for 14. 11%. The irrational problems were mainly irrational usage and dosage,irrational course of treatment,and no irrational prescription of drug administration scheme. Conclusion The use of anti-Hp drugs in outpatient department of our hospital is basically reasonable,but the course of treatment and drug selection still need to be further improved.