我院抗菌药物合理应用干预机制的构建探讨  

Construction and Discussion of Intervention Mechanism of Rational Use of Antibacterial Drugs in Our Hospital

作　　者：张璞[1] 郭燕萍[1] 王斌 钟明康[1] 

机构地区：[1]复旦大学附属华山医院药剂科,上海市200040

出　　处：《中国药房》2011年第46期4349-4353,共5页China Pharmacy

摘　　要：目的:完善我院抗菌药物合理应用干预的机制。方法:结合上海市《抗菌药物临床应用指导原则实施细则》(简称《实施细则》),将我院病房2006年9月1日-2007年2月28日(《实施细则》出台前半年,第一阶段)、2007年3月1日-8月31日(《实施细则》出台后半年,第二阶段)、2007年9月1日-2008年2月29日(实施合理用药机制半年后,第三阶段)各500份病历及2010年(实施合理用药机制1年后,第四阶段)的400份病历(每季度各100份),根据患者手术与否分为手术组与非手术组,评价其用药合理性。结果:《实施细则》出台后,手术组和非手术组患者第二阶段抗菌药物平均费用由第一阶段的2101.79元/1708.64元下降至1408.47元/976.19元,手术组平均用药时间由8.45d减少至5.26d。第三阶段,通过实施干预措施,手术组和非手术组患者用药品种数由1.77种/1.89种下降至1.55种/1.77种。第四阶段,手术组患者用药品种数由1.55种下降至1.30种,用药金额手术组和非手术组患者由1689.04元/1214.52元下降至1155.96元/897.23元。结论:干预机制的建立,一定程度上降低了抗菌药物的用量,减少了不合理用药事件的发生,节约了医疗资源。OBJECTIVE：To improve intervention mechanism of rational use of antibacterial drugs in our hospital.METHODS：Based on Rules for the Implementation of Guidance Principle for Clinical Use of Antibacterial Drugs（called Implementation Rules）,500 medical records were collected from wards of our hospital during Sept.1st,2006-Feb.28th,2007（half year before the issue of Implementation Rules,the first stage）,Mar.1st-Aug.31st in 2007（half year after the issue of Implementation Rules,the second stage）,Sept.1st,2007-Feb.29th,2008（half year after the implementation of rational drug use mechanism,the third stage）,respectively.100 medical records were collected from each quarter of 2010（one year after the implementation of rational drug use mechanism,the forth stage）with a total of 400 medical records.According to whether they underwent operation,those medical records were divided into operation group and non-operation group to evaluate the rationality of antibacterial use.RESULTS：After the issue of Implementation Rules,the average costs of antibacterial drugs in operation group and non-operation group were slightly decreased from 2 101.79 yuan and 1 708.64 yuan in the first stage to 1 408.47 yuan and 976.19 yuan in second stage.The duration of drug use in operation group was dramatically dropped from 8.45 d to 5.26 d.In the third stage,the number of drug used was decreased from 1.77 kinds to 1.55 kinds in operation group and from 1.89 kinds to 1.77 kinds in non-operation group after intervention;In the forth stage,the number of drug used was decreased from 1.55 kinds to 1.30 kinds in operation group,the drug cost decreased from 1 689.04 yuan to 1 155.96 yuan in operation group and from 1 214.52 yuan to 897.23 yuan in non-operation group.CONCLUSION：The establishment of intervention mechanism reduces the amount of antibacterial drugs to some extent,decreases the occurrence of irrational drug use and saves medical resource.

关 键 词：抗菌药物 指导原则 合理用药 干预机制 应用 

分 类 号：R969.3[医药卫生—药理学] R287[医药卫生—药学]