2013年某中医院骨科病区抗菌药物使用与细菌耐药性分析  

Analysis on Application of Antimicrobial Drugs and Bacterial Resistance in Orthopedics Department of A TCM Hospital in 2013

作　　者：孙毅东[1] 张美容[2] 张劲新[1] 叶凌云[1] 林爱华[1] 

机构地区：[1]广东省中医院珠海医院,广东珠海519015 [2]中山大学附属第五医院

出　　处：《中国执业药师》2015年第5期7-11,20,共6页China Licensed Pharmacist

摘　　要：目的:调查我院骨科病区抗菌药物的应用及细菌学情况,为提高抗菌药物合理应用水平提供依据。方法:采用回顾性调查方法,对骨科病区2013年1-12月抗菌药物的使用情况、细菌学检查结果及其耐药性进行统计、分析。结果:各类抗菌药物使用按用药频度(DDDs)排序,前3位分别为头孢菌素类(9 536.4)、青霉素类(613.9)和喹诺酮类(445.0);抗菌药物前3位分别为头孢硫脒(3 036.7)、头孢唑林(2 293.0)、头孢呋辛(1 688.5)。2013年骨科病区送检标本检出的146株细菌中,G-菌100株(68.5%),主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌;G+菌31株(21.2%),主要为金黄色葡萄球菌;真菌15株(10.3%),主要为白色念珠菌。检出菌株中G+菌药物敏感率较高,G-菌和真菌对DDDs排序前列的药物敏感率较低。结论:2013年度我院骨科病区抗菌药物的使用没有导致常见感染菌株出现广泛耐药。骨科病区严格把握抗菌药物使用指征,相对合理的用法用量,是细菌耐药率较低的主要原因;中药的辨证使用是骨科病区细菌耐药率低的可能原因之一。Objective：To investigate the application of antimicrobial drugs and bacteriology in orthopedics department of our hospital so as to provide a clinical reference for the rational use of antimicrobial agents. Methods：The application of antimicrobial drugs, the results of bacterial examination and bacterial resistance in orthopedics department of our hospital in 2013 were analyzed statistically by a retrospective investigation method. Results：The top three drug categories based on the DDDs sequence of the use of antibacterials were cephalosporins（9 536.4）,penicillins（ 613. 9） and quinolones（ 445. 0）, and the top three drugs were cefathiamidine（ 3 036. 7）, cefazolin（ 2 293.0） and cefuroxime（ 1 688.5）. In l46 strains of detected bacteria, 100 strains were Gram-negative bacteria（ 68.5%）, including Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa, 31 strains were Gram-positive bacteria（21.2%）which was mainly Staphylococcus, and 15 strains of fungi（10.3%）, of which Candida albicans was the main part. The drug sensitive rate of Gram-positive bacteria was higher, but Gram-negative bacteria and fungi had a lower drug sensitivity rate of antimicrobial agents ranked at forefront of DDDs. Conclusion：The application of antimicrobial drugs did not lead to an extensive bacterial resistance in orthopedics department of our hospital in 2013. The strict grasp of drug use indications and reasonable administration of antimicrobial drugs were critical points to obtain a low rate of bacterial resistance. Traditional Chinese medicine syndrome differentiation was one of the possible reasons.

关 键 词：抗菌药物 细菌耐药性 用药频度 合理用药 骨科病区 

分 类 号：R969.3[医药卫生—药理学]