某高校医院抗生素用药概况及社会影响因素分析

Analysis of the General Situation and Social Influencing Factors of Antibiotic Use in a University Hospital

目的调查某高校校医院抗生素用药概况,探讨抗生素不合理用药问题,并从社会因素角度分析其原因。方法收取本院2021年5月至2022年5月的门诊处方500张,其中抗生素处方216张。抗生素处方中抗生素不合理用药处方136张,针对这136名就诊患者进行社会因素问卷调查。结果500张处方中,使用抗生素的处方占所有处方的43.20%。抗生素不合理用药处方占抗生素处方的62.96%。分析136张抗生素不合理用药处方得出,无指征用药、用法用量不当以及药物选择不当的处方数占不合理处方的比例分别为73.53%、15.44%、4.41%。对136份调查问卷进行统计分析,医院规定未更新的总符合率高于医保不报销及医院流程不规范(χ^(2)=101.512,P<0.05)。结论该校医院抗生素用药存在一定的不合理情况,医院管理不严格、新规执行不到位是影响抗生素使用的重要社会因素。故而实施医院规范化管理,且对具有明确适应征的患者注意抗生素给药的剂量、途径以及疗程,可为实际工作中的抗生素合理用药提供治疗上的医学依据,减少抗生素滥用情况的发生。

Objective To investigate the general situation of antibiotic use in a university hospital,discuss the problem of irrational use of antibiotics,and analyze its causes from the perspective of social factors.Methods 500 outpatient prescriptions from May 2021 to May 2022 were collected,including 216 antibiotic prescriptions.There were 136 irrational antibiotic prescriptions in the antibiotic prescriptions.A questionnaire survey was conducted on the social factors of these 136 patients.Results Among the 500 prescriptions,antibiotics accounted for 43.20%of all prescriptions.The irrational use of antibiotics accounted for 62.96%of antibiotic prescriptions.The analysis of 136 irrational antibiotic prescriptions showed that the proportion of prescriptions with no indication,improper use and dosage,and improper drug selection in irrational prescriptions was 73.53%,15.44%,and 4.41%,respectively.According to the statistical analysis of 136 questionnaires,the total compliance rate of the hospital′s regulations that were not updated was higher than that of the medical insurance that was not reimbursed and the hospital′s process was not standardized(χ2=101.512,P<0.05).Conclusion The use of antibiotics in the university hospital is unreasonable.The hospital management is not strict and the implementation of new regulations is not in place,which is an important social factor affecting the use of antibiotics.Therefore,implementing standardized hospital management and paying attention to the dosage,route and course of antibiotic administration for patients with clear indications can provide medical basis for rational use of antibiotics in practical work and reduce the occurrence of antibiotic abuse.