2020年我院儿科门急诊泌尿系感染抗菌药物处方点评分析

Analysis of Antibiotics Prescription Reviews for Urinary Tract Infectionsin Pediatric Outpatient and Emergency of Our Hospital in 2020

目的了解广州市妇女儿童医疗中心(以下简称“我院”)儿科门急诊泌尿系感染患儿的抗菌药物使用情况,为儿科泌尿系感染合理用药提供参考。方法从HIS系统抽取2020年1~12月的门急诊儿科泌尿系统抗感染的处方1595张。依据相关指南、共识或其他资料进行点评,对不合理处方进行分类统计,并利用帕累托图分析我院用于儿童泌尿系感染的主要药物种类。结果我院遴选的泌尿系感染抗菌药物中,主要药物为头孢地尼、头孢泊肟酯、头孢克洛以及注射用拉氧头孢钠。而所抽取的1595张泌尿系感染抗菌药物处方中,合理处方共1535张,处方合理率为96.24%。不合理处方共60张,包括遴选药品不适宜38例次,剂型或给药途径不适宜3例次,用法用量不适宜10例次,联合用药不适宜1例次,有配伍禁忌或溶媒选择不适宜1例次以及需皮试后使用但没有进行皮试的7例次。结论我院儿科门急诊泌尿系统抗感染药物的使用虽存在少量不合理情况,但总体情况较好,通过处方统计分析点评,可更直观发现主要问题,有利于医院及时进行干预,促进合理用药。

OBJECTIVE To investigate the use of antibiotics in urinary tract infections of pediatric outpatient and emergency department of Guangzhou Women and Children's Medical Center(hereinafter referred to as"our hospital"),in order to get suggestions for rational drug use of pediatric urinary tract infections.METHODS 1595 anti-infective prescriptions of urinary system of pediatric outpatient and emergency were collected from our HIS system from January 2020 to December 2020.The rationality of the drug use was reviewed according to relevant guidelines,clinical consensus,or database,and unreasonable prescriptions were classified and counted.The main kinds of drugs were analyzed by Pareto chart.RESULTS Cefdinir,cefpodoxime proxetil,cefaclor and latamoxef sodium for injection were the main antibiotics drugs selected for urinary tract infections by our hospital.1535 were rational among 1595,accounting for 96.24%,of antibiotics prescriptions for urinary system infection.60 prescriptions were irrational for drug use,including 38 cases of unreasonable drug selection,3 of unsuitable dosage form or administration route,10 of unsuitable usage or dosage,1 of unreasonable drug combination,1 of unsuitable choice of solvent or pharmaceutic incompatibility and 7 of missing skin test before using.CONCLUSION Although some irrational uses of antibiotics still exist,the overall situation is in excellent condition.The main problems can be found more directly by the statistical analysis and the reviews of prescriptions,which is conducive to the timely intervention by the hospital and the promotion of rational drug use.