抗菌药物相关指标在专项整治中的变化分析  

Analysis of antibiotic related index variations in special rectification

作　　者：刘子昀 刘冬[1] 张晋[1] 张晓钰[1] 姜凤丽[1] 乌伊萍 

机构地区：[1]陕西省宝鸡市中心医院临床药学室,721008

出　　处：《中国医药》2016年第11期1695-1699,共5页China Medicine

基　　金：陕西省卫生厅卫生科研基金（2010H42）

摘　　要：目的分析抗菌药物相关指标在专项整治中的变化。方法统计并分析2011、2013、2015年陕西省宝鸡市中心医院的抗菌药物相关指标、抗菌药物使用强度（AUD）前十名药品品种和构成比率、各科室住院患者抗菌药物使用率在3年的变化。结果整治前后的2015年与2011年比较，住院患者抗菌药物使用率由61．5％下降至48．7％；AUD由56．9下降至41．3；Ⅰ类切口预防使用率由95．0％下降至19．0％；住院患者人均抗菌药物费用、抗菌药物费用占药费总额的百分比也均呈逐年下降趋势，而住院患者人均药品费用、Ⅰ类切口预防使用疗程下降趋势不明显。AUD前十名药品中第1、2代头孢菌素AUD由2011年的6．2升至2015年的13．5，喹诺酮类药物由2011年的6．1降至2015年的2．9。绝大多数科室住院患者抗菌药物使用率有所下降，下降幅度大的科室集中在Ⅰ类切口手术科室和介入诊断治疗的科室，包括眼科、乳腺科、普通外科、骨病科、肿瘤外科、心内科，2015年比2011年总降低值分别为42．6％、39．7％、35．6％、29．1％、23．2％、21．6％，而妇科和产科使用率却略有上升。结论抗菌药物专项整治活动取得了明显效果，多数指标呈下降趋势，构成比趋于合理。但在Ⅰ类切口预防用药品种选择与疗程方面合理性有待提高，科室应按病种、手术种类进一步规范抗菌药物的使用。Objective To analyze changes of related indexes in special rectification of antibiotics. Methods Antibiotic related indexes and varieties of top ten antibiotic use density （AUD） of drugs and inpatient antibiotic use rates of different clinical departments in 2011, 2013 and 2015 in Central Hospital of Baoji City were analyzed through statistical methods. Results From 2011 to 2015, inpatient antibiotic use rate decreased from 61.5% to 48.7% ; AUD decreased from 56. 9 to 41.3 ; the use rate of prophylactic antibiotics for type I incision decreased from 95.0% to 19.0%. The per capita expense of antibiotics of inpatients and the proportion of antibiotic expenses in total drug expenses significantly decreased every year ; the per capita expense of total drugs of inpatients and the treatment course of prophylactic antibiotics for type I incision did not decrease significantly. In top ten AUD of drugs, AUD of first and second generation cephalosporins increased from 6. 2 to 13.5 ; the AUD of quinolones decreased from 6. 1 to 2.9. Inpatient antibiotic use rates decreased in most clinical departments; futhermore, type I operative incision and interventional treatment showed significant downtrend, including ophthalmology, breast surgery, general surgery, orthopedics, surgical oncology and cardiology departments （42. 6%, 39. 7%, 35.6%, 29. 1%, 23.2% and 21.6%, respectively） ; whereas inpatient antibiotic use rates in gynecology and obstetrics departments slightly increased. Conclusions The special rectification of antibiotics shows significantly results. But the medication selection and treatment course of prophylactic antibiotics for type [ incision are not optimistic. The application of antibiotics needs standardization.

关 键 词：抗菌药物 专项整治 使用率 使用强度 

分 类 号：R97[医药卫生—药品]