建德市17家基层卫生院门、急诊抗菌药物处方合理性分析

Rationality analysis of the antibiotic prescription after intervention of outpatient service and emergency treatment in 17 primary hospitals of Jiande City

目的调查分析建德市17家基层卫生院门、急诊抗菌药物处方合理性,查找其存在的问题,评价其合理性,为抗菌药物的合理使用和规范管理提供科学依据。方法选取2015年10月建德市17家基层卫生院门、急诊干预后抗菌药物处方各100张,按照建立的门、急诊处方抗菌药物使用合理性评价标准,对处方进行合理性分析。结果抗菌药物注射给药占47.3%(804/1990);两种抗菌药物联合用药282例(16.6%),三联用药4例(0.2%);抗菌药物不合理使用的处方共354张(20.8%),其中使用方法不合理的处方占所有不合理处方的47.5%(168例)。结论本地区抗菌药物使用在用药指征、品种选择、使用方法、联合用药等各方面依然存在问题,市药事管理质控中心应加强对基层卫生院抗菌药物相关知识培训,增强医务人员合理使用抗菌药物的意识,同时进一步加大监管力度,采取多项切实有效的管理措施规范抗菌药物的使用,提高基层卫生院的合理用药水平。

Objective To investigate and analyze the rationality of antibiotic prescription after the intervention of outpatient service and emergency treatment in 17 primary hospitals of Jiande city,and look for the problems and reasons,so as to provide a scientific basis for the rational use of antibiotics and standardize management. Methods 100 prescriptions were selected respectively during October 2015 from 17 primary hospitals after intervention of outpatient and emergency department in Jiande city,analyzed reasonably the antibiotic prescriptions according to the usage evaluation standard of antibiotic prescription in outpatient and emergency department. Results Antibacterial drug injected accounted for 47. 3%( 804 /1990); two kinds of antibacterial drugs joint using were 282 cases( 16. 6%),triple therapy were 4 cases( 0. 2%); the irrational use of antibiotics prescriptions were 354( 20. 8%),of which unreasonable use of prescriptions accounted for 47. 5% of all of unreasonable prescriptions( 168 cases). Conclusion There are still many problems in medication indications,species selection,using method,drug combination et al. The City Center of Pharmaceutical Affairs Management Quality Control should strengthen the related antibacterial drug knowledge training to the basic- level hospitals,enhance the consciousness of rational use of antimicrobial agents to medical staff,strengthen supervision at the same time,take a number of practical and effective management measures to standardize the use of antimicrobial agents and raise the level of basic- level hospitals of rational drug use.