某三甲医院专项整治前后住院患者抗菌药使用及医院感染情况对比  

Contrastive Analysis of the Antimicrobial Use and Nosocomial Infection in Inpatients of A Third-grade Class-A Hospital Before and After the Special Rectification

作　　者：吴静[1] 王萍[1] 周鸣[1] 沈双双[2] 

机构地区：[1]南京医科大学第二附属医院药剂科,南京210011 [2]南京医科大学药学院

出　　处：《药物流行病学杂志》2014年第3期177-181,共5页Chinese Journal of Pharmacoepidemiology

摘　　要：目的：了解专项整治前后某三甲医院住院患者抗菌药使用情况及医院感染率的变化，为抗菌药的管理提供依据。方法： 调取某三甲医院2010年7～12月（整治前）和2012年7～12月（整治后）住院患者抗菌药使用数据，并进行统计分析。结果：该院专项整治前后抗菌药8项指标发生明显变化：住院患者抗菌药使用率分别为75.84%和54.46%、使用强度（AUD）分别为82.63和52.77 DDD/100人天、特殊使用类抗菌药使用量占抗菌药总使用量比例分别为21.33%和12.73%、Ⅰ类切口手术预防用抗菌药比例分别为100%和45%、介入诊疗手术预防用抗菌药比例分别为100%和0%、治疗用药微生物检验样本送检率分别为38%和43%、住院患者人均使用抗菌药费用分别为1 455元和812元、抗菌药费用占药物总费用比例分别为28.98%和14.38%，手术科室的变化尤为明显，医院感染率有所降低。结论：某三甲医院通过实施抗菌药物专项整治和双重干预措施，各项抗菌药应用指标发生明显改善，且多项指标已符合卫生部规定，专项整治的效果比较明显。重症医学室（ICU）的抗菌药使用方面仍然需要提出更具效果的措施，加强监管。Objective：To investigate the changes of antimicrobial use index and nosocomial infection rate in hospitalized patients of a top three hospital before and after the special rectification to provide a basis for antimicrobial management. Methods：The basic data of antimicrobial use were collected in the hospital during July December in 2010（before rectification）and July December in 2012 （after rectification）,and were statistically analysed. Methods：Some significant changes took place in 8 antimicrobial use indexes of the third grade class A hospital before and after the special rectification. The proportions of antimicrobial use were respectively 75.84% and 54.46%. AUD were 82.63 and 52.77 DDD/100 persons/d,respectively. The proportions of antibiotics for special use in total amount were 21.33% and 12.73%,respectively. The proportions of prophylactic application of antibiotics for type Ⅰ incision were 100% and 45%,respectively. The interventional diagnosis and treatment were 100% and 0%,respectively. The proportions of microbial test sample submission for treatmented drugs were 38% and 43%,respectively. The antibiotics cost of inpatients per capita were 1 455 yuan and 812 yuan,respectively. The proportions of antibiotics cost in total drug cost were 28.98% and 14.38%,respectively. The index changes were obvious especially in the operation departments, but the nosocomial infection rate decreased. Conclusion： Through the implementation of antibacterial special rectification and double intervention in the hospital,the antimicrobial use indexes improved significantly, and multiterm indexes met with the regulation of the Ministry of Public Health, and the effect of the special rectification was obvious. However, it is necessary to put forward more effective measures and strengthen supervision of the antimicrobial use in ICU.

关 键 词：抗菌药 专项整治 使用强度 特殊使用级 医院感染 合理用药 

分 类 号：R978.1[医药卫生—药品]