33所中心乡镇卫生院抗菌药物使用调查  

Antimicrobial use in 33 township central hospitals

作　　者：唐强[1] 尹辉明[1] 吴卫华[2] 李芬[1] 谢若青 郭燕华[1] 李燕华[1] 凌建新[1] 刘建锋[1] 

机构地区：[1]怀化医专附属怀化市第三人民医院,湖南怀化418000 [2]怀化医学高等专科学校,湖南怀化418000

出　　处：《中国感染控制杂志》2014年第11期654-658,共5页Chinese Journal of Infection Control

基　　金：湖南省科技项目(2014SK3129);怀化市科技项目([2013]4号1-15-2)

摘　　要：目的调查某市中心乡镇卫生院抗菌药物的使用现状,以促进抗菌药物合理使用。方法随机抽取湖南省某地级市11个县市33所中心乡镇卫生院,对其门诊处方7 920张,非手术患者病历资料465份,手术患者病历资料213份进行调查分析。结果 33所中心乡镇卫生院门诊、住院患者抗菌药物使用率分别为56.60%、89.68%,联合用药率分别为24.16%、43.58%。住院患者抗菌药物使用强度为147.25 DDDs。手术患者抗菌药物使用率为97.18%,联合用药率为59.90%,其中单一、二联、三联及以上用药分别占40.10%、47.82%、12.08%。Ⅰ、Ⅱ、Ⅲ类切口手术患者抗菌药物使用率分别为97.56%(40/41)、96.93%(158/163)、100.00%(9/9),联合用药率分别为30.00%、67.72%、44.44%。结论该地级市33所中心乡镇卫生院存在普遍过度使用抗菌药物的现象,其抗菌药物使用率、联合用药率、住院患者抗菌药物使用强度及Ⅰ类切口抗菌药物预防使用率均较高。Objective To investigate antimicrobial use in 33 township central hospitals, and improve the rational use of antimicrobial agents. Methods Thirty-three township central hospitals in 11 counties were randomly select- ed, 7 920 outpatient prescriptions, medical records of 465 non-surgery patients and 213 surgery patients were inves- tigated and analyzed. Results Of 33 hospitals, antimicrobial usage rate in outpatients and inpatients was 56.60 and 89.68% respectively,combined antimicrobial usage rate was 24. 16% and 43.58% respectively. Antimicrobial use density in inpatients was 147. 25DDDs. Antimicrobial usage rate in surgery patients was 97. 18%, combined an- timicrobial usage rate was 59.90%, the percentage of one drug, two-drug combination and three-drug combination was 40.10%, 47.82%, and 12.08% respectively. The percentage of antimicrobial use in patients of type Ⅰ ,Ⅱ, and Ⅲ incision was 97.56%（40/41）, 96.93% （158/163） and 100.00%（9/9）respectively,combined antimicrobial us- age rate was 30.00% ,67.72%, and 44. 44% respectively. Conclusion The overuse of antimicrobial agents exists in 33 township central hospitals, antimicrobial usage rate, combined usage rate, antimicrobial use density and antimi- crobial prophylaxis in type I incision operations are all high.

关 键 词：乡镇卫生院 手术类型 抗菌药物 合理用药 门诊处方 

分 类 号：R969.3[医药卫生—药理学]