我区5家医疗卫生机构实施《抗菌药物临床应用管理办法》前后抗菌药物应用分析  

Analysis of Antibiotics Application in Five Hospitals in Our District before and after the Implementation of Measures for the Management of Clinical Use of Antibiotics

作　　者：舒薇[1] 任世禾[2] 蒋瑾 刘基炎 李锦[5] 徐剑良[1] 周剑斌[1] 后晓群[1] 钱豪英 彭程[1] 葛婷捷[1] 

机构地区：[1]上海市闸北区中心医院药剂科,上海200070 [2]上海市中医医院药剂科,上海200071 [3]上海市北站医院药剂科,上海200070 [4]上海市闸北区芷江西社区卫生服务中心,上海200070 [5]上海市闸北区彭浦社区卫生服务中心,上海200435

出　　处：《中国药房》2015年第17期2314-2318,共5页China Pharmacy

基　　金：上海市闸北区科委课题项目(No.2011YB01)

摘　　要：目的:评价我区5家医疗卫生机构实施《抗菌药物临床应用管理办法》的效果。方法:调取《抗菌药物临床应用管理办法》(以下简称"《办法》")实施前(2010-2011年)、实施后(2012-2013年)上海市闸北区5家医疗卫生机构抗菌药物应用数据,采用Excel对用药频度(DDDs)进行统计分析。结果:《办法》实施后5家医疗卫生机构抗菌药物总DDDs下降29.75%,门诊和住院患者特殊使用级抗菌药物DDDs分别下降100%和27.91%;《办法》实施后门诊患者氨基糖苷类DDDs较实施前下降68.26%,住院患者喹诺酮类和氨基糖苷类DDDs较实施前下降26.88%、22.20%;《办法》实施后5家医疗卫生机构门诊和住院患者抗菌药物使用率等应用指标均已达标,其中Ⅸ类切口手术预防使用抗菌药物比例、预防使用抗菌药物时间≤24 h的比例、抗菌药物使用强度这3项应用指标趋于好转,与《办法》实施前相比,差异有统计学意义(P<0.01)。结论:《办法》的颁布对抗菌药物的使用起到了一定的指导和制约作用,但Ⅸ类切口手术预防使用抗菌药物以及抗菌药物使用强度距离达标尚有差距。OBJECTIVE： To evaluate the effect of the implementation of Measures for the Management of Clinical Use of Antibiotics in 5 hospital of Shanghai Zhabei district. METHODS ： The data of antibiotics in 5 hospitals in Shanghai Zhabei district be- fore （from Jan. 2010 to Dec. 2011） and after （from Jan. 2012 to Dec. 2013） the implementation of Measures for the Management of Clinical Use of Antibiotics （hereinafter referred to measures） was collected and the DDDs were analyzed by Excel. RESULTS： After the implementation of measures, the total DDDs in 5 hospitals was decreased 29.75% and the DDDs of antibiotics for special purpose in inpatients and outpatients were respectively decreased 100% and 27.91%; the DDDs of aminoglycosides in outpatients were decreased 68.26% and the DDDs of fluoroquinolones and aminoglyeosides in inpatients were respectively decreased 26.88% and 22.20% ; the utilization rate of antibiotics in outpatients and inpatients in 5 hospitals was reached the standard and proportions of prophylactic application of antibiotics and the course for no more than 24 h in type I incision surgery and the antibiotic use density were all improved. Compared with before, there was significant difference （P〈0.01）. CONCLUSIONS： The implementation of measures has certain guiding and restraining effects on the antibiotics use, but there is a gap between the prophylactic use of antibiotics in type I incision operation, the antibiotic use and the standard.

关 键 词：抗菌药物 用药频度 合理用药 

分 类 号：R969.3[医药卫生—药理学]