临床药师干预妇产科专科医院抗菌药物的应用实践  

Application Practice of Antibiotics by Clinical Pharmacists in Obstetrics and Gynecology Hospital

作　　者：金经[1] 王先利[1] 庞艳玉[1] 王萌萌[1] 王晶[1] 杨振宇[1] 

机构地区：[1]复旦大学附属妇产科医院药剂科,上海200011

出　　处：《中国医院用药评价与分析》2016年第6期836-840,共5页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:探讨临床药师入驻病房干预抗菌药物应用的成效。方法:临床药师每日入驻重点病房审核抗菌药物医嘱,针对发现的不合理情况,与医师、病房主任讨论沟通,探讨如何避免药物不合理应用的发生。结果:临床药师定期与医院各个科室进行沟通,制订了相应的整改措施。通过临床药师干预,妇科病房A、B住院患者抗菌药物使用率由干预前的(65.59±3.91)%降到了干预后的(57.68±6.52)%;抗菌药物使用强度由(61.03±19.18)DDDs/(100人·d)降到了干预后的(42.27±23.54)DDDs/(100人·d);I类切口预防性使用率由干预前的(28.82±4.99)%降到了干预后的(14.14±7.06)%,差异均有统计学意义(P<0.05)。特殊使用类抗菌药物使用率、使用强度及新生儿科抗菌药物使用率、使用强度均有不同程度的降低。干预后,病房抗菌药物消耗量及使用时间均呈不同比例的下降;抗菌药物销售金额明显下降,其在药物费用及住院总费用占比下降,住院总费用降低。结论:临床药师入驻病房实时干预抗菌药物可促进抗菌药物合理应用,也为现阶段国内临床药师抗菌药物管理工作模式的研究提供有价值的参考。OBJECTIVE：To probe into the effectiveness of clinical pharmacists ’ real-time intervention of antibiotics application in obstetrics and gynecology hospital .METHODS： The clinical pharmacists settled in key inpatient ward to check doctor ’s advice of antibiotics everyday , and fund out the irrational phenomenon;and then took face to face or leave a tip modes to communicate with physicians about the key irrational problems per month . RESULTS：The clinical pharmacists reported the inspection results and related indicators at a fixed time to the dean who is in charge of the matters , and formulated rectification measures under the help of medical department and quality control department .Via the intervention of the clinical pharmacists , the application rate , use intensity of inpatient antibiotics , and the proportion of antibiotics in type I incision patients were all decreased significantly .The application rate of type I incision in two wards of department of gynaecology decreased from （28.82 ±4.99）%before intervention to （14.14 ±7.06）%after intervention , application rate of antibiotics decreased from （65.59 ±3.91）%to （57.68 ± 6.52 ）%, and use intensify decreased from （ 61.03 ±19.18 ） DDDs/（ 100 people？d ） to （ 42.27 ±23.54 ） DDDs/（100 people？ d）, with statistically significant difference（P〈0.05）.The application rate, use intensify of antibiotics for special use and antibiotics in neonatology department were decreased to different extent .CONCLUSIONS： The intervention in application of antibiotics by clinical pharmacists in ward is effective and practicable , which play important roles in promoting safe , effective and economic application of antibiotics , and provide valuable reference for exploring the work mode of clinical pharmacists .

关 键 词：妇产科医院 临床药师 抗菌药物 用药干预 

分 类 号：R969.3[医药卫生—药理学]