某三甲医院抗菌药物临床应用专项整治活动效果分析  

Effectiveness of special rectification activity on clinical antimicrobial use in a tertiary first-class hospital

作　　者：周陶友[1] 陈相军[1] 管玫[1] 李念[1] 刘芳[1] 于磊[1] 黄应德 陈敏[1] 

机构地区：[1]四川大学华西医院,四川成都610041

出　　处：《中国感染控制杂志》2015年第3期202-204,210,共4页Chinese Journal of Infection Control

摘　　要：目的了解某三甲医院抗菌药物临床应用专项整治活动前后抗菌药物使用情况。方法抽取四川省某三甲医院2011年1月—2013年12月的抗菌药物使用数据,对抗菌药物品种、门急诊抗菌药物处方比例、住院患者抗菌药物使用费用占总费用比、抗菌药物使用率和使用强度、特殊使用级抗菌药物使用率和使用强度、接受限制和特殊使用级抗菌药物患者微生物送检率等数据进行回顾性分析。结果抗菌药物临床应用整治活动前,医院抗菌药物品种有88种,整治后一直保持在50种。整治活动后门急诊抗菌药物处方比和住院抗菌药物费用占总费用比均小于整治活动前(均P<0.05)。整治前后抗菌药物使用率、特殊使用级抗菌药物使用率比较,差异均有统计学意义(均P<0.05)。整治后接受限制和特殊使用级抗菌药物患者的微生物送检率也显著高于整治前(均P<0.05)。整治后医院Ⅰ类切口手术围手术期抗菌药物预防用药率低于整治前,而术前30 min^2 h用药比例高于整治前(均P<0.05)。结论 3年专项整治使医院抗菌药物的使用更趋合理,但仍需进一步加强管理,促进抗菌药物合理应用工作持续改进。Objective To investigate the application of antimicrobial agents in a tertiary first-class hospital before and after implementing special rectification activity on clinical antimicrobial use.Methods Data about antimicrobial use in a hospital in Sichuan Province between January 2011 and December 2013 were collected and analyzed retrospectively,data included antimicrobial varieties,the ratio of antimicrobial prescription in outpatient department to emergency department,percentage of antimicrobial application expense in the total hospitalization expense,antimicrobial use rate and use density,antimicrobial use rate and use density of special use antimicrobial agents,microbial detection for patients receiving restricted and special antimicrobials.Results Before implementing rectification of an-timicrobial use,there were 88 kinds of antimicrobial agents in hospital,after implementing rectification,there were 50 kinds of antimicrobial agents.The ratio of antimicrobial prescription in outpatient department to emergency department,and the percentage of antimicrobial expense in the total hospitalization expense were both lower than before rectification （both P〈0.05 ）.Antimicrobial use rate and antimicrobial use rate of special use antimicrobial agents before and after rectification were all statistically different（all P〈0.05）.Compared with before rectification, microbial detection rate of specimens from patients receiving restricted and special use antimicrobial agents improved significantly （both P〈0.05 ）.Perioperative antimicrobial prophylactic use rate in patients with class Ⅰincisional operation after rectification was lower than before rectification,while percentage of antimicrobials used 30 min-2 h before operation was higher than before rectification （both P〈0.05）.Conclusion After three year special rectification,antimicrobial use become more rational,but management still needs further and continuous improvement.

关 键 词：抗菌药物管理 抗菌药物使用强度 三甲医院 合理用药 围手术期 

分 类 号：R181.32[医药卫生—流行病学]