安徽省农村基层医疗机构呼吸系统疾病患者抗菌药物处方分析

Analysis of prescriptions of antibiotics for patients withrespiratory diseases in rural primary health care facilities inAnhui Province

目的分析安徽省农村基层医疗机构呼吸系统疾病患者抗菌药物处方特征,为今后规制基层医生抗菌药物处方行为提供干预重点和建议。方法采用分层随机抽样的方法在安徽省4个县(区)的乡镇卫生院、村卫生室两级医疗机构招募呼吸系统疾病患者,分析其处方的抗菌药物使用情况。结果共招募呼吸系统患者1068例,诊断为上呼吸道感染的最多326例,占30.52%。呼吸系统疾病患者的抗菌药物处方率为88.01%,联合用药率为40.96%,注射型抗菌药物使用率为49.57%,村卫生室在前两方面的比率均高于乡镇卫生院。处方中使用最多的抗菌药物为广谱青霉素类,占29.21%。结论农村基层医疗机构在治疗呼吸系统疾病方面存在抗菌药物不合理使用现象,村卫生室较为突出;国家要重点关注农村基层医疗机构抗菌药物使用情况,可从政府、医生和患者三方出发,构建多位一体的抗菌药物合理使用环境。

Objective To analyze the prescription of antibiotics for patients with respiratory diseases in rural primary health care facilities in Anhui Province,so as to identify intervention target and potential strategies for regulating the antibiotics prescribing behavior of primary health care providers in the future.Methods Patients with respiratory diseases were recruited from township health centers and village clinics in four counties(districts)in Anhui Province using stratified random sampling.The use of antibiotics in their prescriptions was analyzed.Results Of 1068 the patients,the diagnosis of upper respiratory tract infection was the most common,accounting for 30.52%.Among the prescriptions for those patients with respiratory disease,88.01%contained antibiotics,40.96%indicated combined use of antibiotics,and 49.57%prescribed injections of antibiotics.The first two proportions were higher in village clinics than in township health centers.The most commonly used antibiotics in the prescriptions were broad-spectrum penicillins,accounting for 29.21%of all the antibiotics prescribed.Conclusions Inappropriate use of antibiotics in the treatment of respiratory diseases is prevalent among primary health care facilities in rural areas,in particular in village clinics.The government should attache significance to the use of antibiotics in rural health care providers.A multifacet environment encouraging the rational use of antibiotics may be built from the perspectives of the government,doctors,and patients.