市级药事质控中心在抗菌药物管理中的作用

The Role of Municipal Pharmaceutical Quality Control Center in the Management of Antimicrobial Drugs

目的探讨市级药事管理质控中心在抗菌药物管理中的作用。方法收集2011—2018年沈阳市30家医院门、急诊抗菌药物处方比例、住院患者抗菌药物使用率和使用强度、住院患者使用抗菌药物的微生物送检率和I类切口手术抗菌药物预防使用率等数据,评价市级质控中心采取一系列抗菌药物管理措施的成效。结果截至2018年,门诊抗菌药物处方比例由2011年的25.17%降至10.32%,急诊抗菌药物处方比例由42.76%降至28.38%,住院患者抗菌药物使用率由69.57%降至37.53%;I类切口手术抗菌药物预防使用率由41.79%降至19.41%;住院患者抗菌药物使用强度由2014年的49.45 DDDs降至35.41 DDDs;与2014年比较,2018年市级医院和厂企医院各项送检率均达标且有很大幅度提高,仅区县医院特殊级送检率变化不大,仍未达国家标准。结论通过多年药事管理,沈阳市药事质控中心在抗菌药物管理中取得了显著成效。

Objective To explore the role of Shenyang Pharmaceutical Administration Quality Control Center in the management of antibiotics.Methods The proportion of prescriptions for antibiotics in outpatient and emergency departments of 30 hospitals in Shenyang from 2011 to 2018,the utilization rate and intensity of antibiotics in inpatients,the microbial inspection rate of antibiotics used by inpatients and the prophylactic use rate of antibiotics in class I incision surgery,was collected to evaluate effectiveness of measures of a series of antibiotics management taken by municipal quality control centers.Results By the end of 2018,the proportion of outpatient antibiotics prescription decreased from 25.17%in 2011 to 10.32%,emergency antibiotics prescription decreased from 42.76%to 28.38%,in-patient antibiotics usage decreased from 69.57%to 37.53%,the prophylactic use rate of antibiotics in class I incision surgery decreased from 41.79%to 19.41%,and in-patient antibiotics usage intensity decreased from 49.45 DDDs in 2014 to 35.41 DDDs;compared with 2014,the inspection delivery rates of municipal hospitals and factory-enterprise hospitals reached the standard in 2018 and increased greatly.Only the special-level inspection delivery rates of district and county hospitals did not change much and still did not reach the national standards.Conclusion Through years of drug administration,Shenyang Pharmaceutical Quality Control Center has achieved remarkable results in the management of antibiotics.