某心脑血管病医院特殊使用级抗菌药物治疗用药分析  

Administration of antibiotics for special use in a cardio-cerebrovascular hospital

作　　者：邓宁[1] 高华[2] 孙维红[2] 朱秀琪[1] 文友民[2] 熊建功[1] 

机构地区：[1]宁夏医科大学总医院心脑血管病医院药剂科,宁夏银川750002 [2]宁夏医科大学总医院药剂科,宁夏银川750004

出　　处：《中华医院感染学杂志》2016年第4期793-796,共4页Chinese Journal of Nosocomiology

基　　金：宁夏回族自治区卫生厅科研基金资助项目(2012045)

摘　　要：目的对特殊使用级抗菌药物非手术患者治疗用药进行评价,为完善特殊级抗菌药物的细化管理提供参考依据。方法回顾性调查2013年7-12月262例非手术患者使用特殊级抗菌药物的临床资料,从患者、科室分布、用药详情、用药频度、用药指数、费用、病原学结果等进行分析,并对各科进行用药合理性评分。结果特殊级抗菌药物使用率排名前3位的临床科室分别为呼吸与危重症医学科、普外科、心血管内科,使用率分别为70.61%、8.40%、6.49%;262例患者临床标本送检181例,送检率为69.08%;共检出病原菌87株,其中革兰阴性菌50株占57.47%,革兰阳性菌19株占21.84%,真菌18株占20.69%;使用特殊级抗菌药物341频次,其中亚胺培南/西司他丁使用频次最高,占33.72%;特殊级联合用药率占37.96%,平均用药疗程为8.92d;平均费用为4 026.73元、占抗菌药物费用的39.59%;特殊使用级抗菌药物合理性评分内科系统平均分为8.24分、外科系统为8.17分、全院总体平均分为8.21分。结论非手术患者特殊级抗菌药物用药基本合理,为质量控制、医务等部门进行细化管理提供了参考依据。OBJECTIVE To evaluate the administration of antibiotics for special use to non-surgical patients so as to provide reference for detailed management of antibiotics for special use.METHODS A retrospective study was conducted on the medical records of non-surgical patients who received antibiotics for special use during Jul.-Dec.2013.The basic condition,distribution of clinical department,utilization of antimicrobial drugs,DDDs,DUI,drug consumption,etiological examination were recorded and analyzed,and a scoring system was used for evaluation of rationality of drug use in each clinical department.RESULTS The departments with the usage rate ranking top 3were the respiratory department（70.61%）,the general surgery department（8.40%）and the cardiology department（6.49%）.A total of 181 specimens were delivered for detection from 262 patients,with the delivery rate of 69.08%.Totally 87 pathogenic strains were detected,including 50gram-negative strains（57.47%）,19 grampositive strains（21.84%）and 18 fungal strains（20.69%）.The antibiotics were administrated in 341case-times,and imipenem/cilastain was used the most frequently accounting for 33.72%.The combination rate of antibiotics for special use was 37.96%,the average course of treatment was 8.92 days.The drug cost was 4026.73 yuan on average for each time of treatment,accounting for 39.59% of the total cost of antibiotic medication.The mean rationality score was 8.24 points for the medical departments and 8.17 points for surgical departments and the total mean score was 8.21 points for the whole hospital.CONCLUSIONThe administration of antibiotics for special use in our hospital is basically reasonable for non-surgical in patients,providing reference for detailed management of departments dealing with quality control and medical affairs.

关 键 词：特殊使用级 抗菌药物 住院患者 非手术 细化管理 药合理性评分 

分 类 号：R453.2[医药卫生—治疗学]