医院外感染抗生素合理应用临床分析  

Clinical Analysis of Appropriate Use of Antibiotics in Community-acquired Infection

作　　者：吕增春[1] 何连德[1] 霍云燕[1] 赵云琴[1] 陈淑敏 傅冠峰[3] 

机构地区：[1]中国人民解放军总医院,100853 [2]航天部721医院感染科,进修医师100037 [3]河南省洛阳市第二人民医院感染科,进修医师471009

出　　处：《药物流行病学杂志》1997年第2期91-93,共3页Chinese Journal of Pharmacoepidemiology

摘　　要：1994年6月随机抽取了全部出院(包括死亡)病案1312份,其中医院外感染197例。对此197例应用抗生素情况进行临床分析。医院外感染主要是下呼吸道感染65例,上呼吸道感染37例,消化道感染24例,腹部感染20例,泌尿系感染12例,口腔和耳鼻喉感染14例,其他严重感染25例。医院外感染197例,共培养出各种致病菌113株。医院外感染197例中,共用抗生素41种,377疗程,2637天,平均每例1.91个疗程,13.39天。按疗程进行评价,应用合理的160疗程(42.44％)、基本合理的117例(31.03％),不合理的100疗程(26.53％)。应用不合理的原因分析:无应用抗菌药物适应症的占首位,共56个疗程(56％);疗程大短,频繁换药的22疗程(22％);疗程太长,包括术后用药>11天者,18疗程(18％)。最后还讨论了:①医院外感染与医院内感染的抗感染治疗共同点和不同点;②医院外感染常用十种抗生素的排列排序;③抗感染药物应用不合理的原因及正确应用抗生素应采取的措施。In June, 1994, 197 patients with community-acquired infection (CAI) from 112 cases who had been hospitalized ware studied. Use of antibiotics in 197 cases of CAI were evaluated for its rationality. The commonest sites of CAI were lower respiratory tract (65 cases), abdominal cavity (20 cases), urinary tract (12 cases) , mouth, ear, nose and throat (14 cases) . 113 strains of bacteria were identified from the 197 patients with CAI. The treatment of the 197 patients involved 377 therapeutic courses and 2637 days of antibiotic use. 160 therapeutic courses (42.44%) appropriate and 100 therapeutic course (26.53%) were inappropriate. The inappropriate use included: 1) absence of indications for the antibiotic use (56 therapeutic courses, 56%); 2) short therapeutic courses and frequent changes of antibiotics (22 therapeutic courses, 22%); 3) long therapeutic courses, including post-operative use of antibiotics longer than 11 days(18 therapeutic courses, 18%). Also discussed are differences in community-acquired infections and hospital-acquired infections, 10 top antibiotics used for community-acquired infection and the causes for inappropriate use of antibiotics and countermeasures.

关 键 词：医院外感染 抗生素 评价标准 合理用药 

分 类 号：R978.1[医药卫生—药品]