住院患者抗菌药物应用调查分析与管理对策  

Antibiotic Drug Use in Inpatients:Survey,Analysis and Management

作　　者：陈雪梅[1] 司徒冰[1] 刘建文[1] 王锡瑜[1] 

机构地区：[1]广州医学院第三附属医院感染管理科,广东广州510150

出　　处：《中华医院感染学杂志》2008年第8期1140-1142,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院抗菌药物的使用情况,为临床合理应用抗菌药物管理提供依据。方法回顾性调查2005年1月-2006年12月出院病历,手术病历810份和非手术病历1220份(其中非手术应用抗菌药物的病历730份),统计与分析抗菌药物使用情况。结果所有应用抗菌药物的病例均符合用药指征,手术患者810例中仅有56例用药完全合理,占6.91%,有754例存在用药不合理,占93.01%,手术病例抗菌药物预防性用药选药档次过高、围手术期用药时间不当等不合理现象较为突出,Ⅰ类切口平均术后预防用药时间6.59 d,Ⅱ类切口平均术后预防用药时间6.44 d;非手术患者抗菌药物应用率59.83%,共有730例,其中有432例用药完全合理,占59.18%,不合理用药298例,占40.82%,以药物用法、用量不当,应做而没有做病原学检查现象较为突出。结论加强抗菌药物合理应用相关培训学习,严格掌握用药原则,建立健全的抗菌药物管理机构和制度是控制抗菌药物合理使用的关键。OBJECTIVE To improve the management of the use of antibiotics in the hospital through investigating and analyzing the cases of inpatients. METHODS From Jan 2005 to Dec 2006, totally 810 cases of operated patients and 1220 cases of non-operated patients were investigated retrospectively, and the usage of antibiotic was analyzed. RESULTS The need of using antibiotic drugs was proven in all cases in which antibiotic drugs were used. However, only 56 cases in the total 810 operated cases used drugs were completely reasonable, which accounted for 6.91%. Unreasonableness was found in the other 754 operated cases（ccounted for 93.01%）, who had used inappropriate antibiotic drugs or those drugs in an improper time during the preoperative period. The average time of using prevention drugs for Type I and Type Ⅱ incisions were 6. 59 and 6. 44 days after the operation, respectively. In the 1220 non-operated cases, only 730 cases used antibiotic drugs, which accounted for 59.83%. From them, 432 cases （accounted for 59.18%） used the antibiotic drugs were completely reasonable and other 298 cases （accounted for 40.82%） were found have used the antibiotic drugs unreasonably. The unreasonableness mainly included in the dose and method used and a lack of examination in the pathogens in some adaptive cases. CONCLUSIONS Enhancing the training and encouraging the study of rational use of antibiotic drugs, establishing and optimizing the management system on the use of antibiotic drugs are the key tasks involved to ensure the reasonable use of the antibiotic drugs.

关 键 词：抗菌药物 合理应用 管理 

分 类 号：R978.1[医药卫生—药品]