上海市第七人民医院2011年专项整治前后抗菌药物应用分析  

Analysis of antibacterials applications before and after special rectification of Shanghai Seventh People's Hospital in 2011

作　　者：张永佳[1] 王慧菁[1] 时扣荣[1] 曹晓莉[1] 顾伟鹰[1] 张立超[1] 

机构地区：[1]上海市第七人民医院药剂科,上海200137

出　　处：《药学服务与研究》2011年第6期412-416,共5页Pharmaceutical Care and Research

基　　金：浦东新区卫生系统重点学科建设项目(No.PWZXK2010-11)

摘　　要：目的:调查上海市第七人民医院2011年专项整治前后抗菌药物的应用情况,为后续管理提供依据。方法:采用回顾性调查法,分专项整治前(1-3月)、整治期间(4-6月)及整治后(7-9月)3组,对2011年1-9月抗菌药物用药金额、用药频度(DDDs)等数据进行统计、分析。结果:抗菌药物应用专项整治后的DDDs分别较整治前、整治期间下降31.68%、21.99%;注射剂与口服药相比,其DDDs降幅更大,比整治前下降45.20%;用药结构变化显著,其中合资产品DDDs增长较大,但构成比仍仅占10.56%。分级管理和Ⅰ类切口手术预防使用管理改进明显,其中特殊使用类抗菌药物的不合理使用率从整治前的75.86%下降至25.00%,而Ⅰ类切口手术抗菌药物预防使用率、用药时间从整治前的97.17%和(4.59±2.04)d,分别下降至37.04%和(1.08±0.97)d。整治前后,抗菌药物联用率未见明显变化;治疗性应用抗菌药物的微生物标本送检率虽有所提高,但总检出阳性率仍维持在15%以下。结论:本次专项整治有助于促进抗菌药物的合理使用,但对治疗性应用抗菌药物的管理尚需加强。Objective： To investigate the clinical application of antibacterials in Shanghai Seventh People＇s Hospital before and after special rectification in 2011 ,in order to provide a basis for follow-up management. Methods： The data of the consump- tion sum,the frequency of medication（DDDs） of antibacterials during January 2011 and September 2011 were retrospectively analyzed,and divided into three groups：before（A group,January to March） ,during（B group,April to June） ,and after（C group, July to September） rectification groups. Results： Compared with A and B groups,the DDDs in C group decreased 31.68 % and 21.99 %, respectively. Decrease extent of DDDs of antibacterials for injection in C group was more significant than that of oral antibacterials,which decreased 45.20% compared with the data of A group. The composition ratio of antibacterial consumption was changed greatly, for example,the DDDs of antibacterials produced by joint venture increased more significant than that of the domestic ones. However, the composition ratio of antibacterials produced by joint venture was only 10. 56%. After rectifica tion,the graded management of antibacterials and the prophylactic application of antibacterials in type I incision operation were improved significantly. The irrational application ratio of antibacterials for special purpose decreased from 75.86% of A group to 25.00% of C group,and the prophylactic application rate and time of antibacterials in type I incision operation droped from 97.17% and （4.59±2.04） d of A group to 37.04% and （1.08±0.97） d of C group. The combination ratio of antibacterials had no significant differences before and after rectification. Although the detection rate of the microbiological specimens in creased, the isolation rate of pathogen was still below 15 %. Conclusion： The special rectification of clinical antibacterials application is feasible and valid to promote rational use of antibacterials. However, measures should be taken to improve the manage ment of

关 键 词：抗菌药物 专项整治 合理用药 回顾性分析 

分 类 号：R969.3[医药卫生—药理学] R978.1[医药卫生—药学]