加强对碳青霉烯类抗菌药物使用管理的效果评价  

Evaluation of the effect of strengthening the management of carbapenem antibiotics

作　　者：陈琳[1] 杨小燕[1] 许小敏[2] 孙一民[3] 蔡挺[4] 胡耀仁[5] 顾吉娜[1] 曾呈军[1] 

机构地区：[1]宁波市第二医院感染科,浙江宁波315010 [2]宁波市第二医院院感管理科,浙江宁波315010 [3]宁波市第二医院药学部,浙江宁波315010 [4]宁波市第二医院急诊科,浙江宁波315010 [5]宁波市第二医院肝病研究所,浙江宁波315010

出　　处：《中华医院感染学杂志》2017年第8期1897-1900,共4页Chinese Journal of Nosocomiology

基　　金：宁波市社发重大专项基金资助项目(2011C51002);浙江省区域专病中心建设学科基金资助项目(2014-98);浙江省自然科学基金资助项目(LY13H190008)

摘　　要：目的通过加强对碳青霉烯类抗菌药物的使用管理,评价管理后的临床效果。方法回顾性分析2016年1月1日-11月30日医院对碳青霉烯类抗菌药物使用管理前后出院患者抗菌药物使用率、患者的平均住院时间、经济学效益、患者的病死率等的变化情况。结果加强管理后总抗菌药物中位使用率分别为42.76%、43.38%,差异无统计学意义;中位碳青霉烯类药物使用率由4.27%降至2.53%(P<0.05);加强管理前后中位平均住院日、人均抗菌药物使用日未见明显增加;中位人均抗菌药物费用较前有下降趋势,分别为1663.46元、1704.12元,差异无统计学意义;加强管理后抗菌药物费用占总费用及药品费用比例较前下降(P<0.05);加强管理后使用抗菌药物患者病死率较前有下降趋势,差异无统计学意义。结论加强对碳青霉烯类抗菌药物使用管理显著降低碳青霉烯类药物的使用率,并在一定程度上降低了人均抗菌药物费用、病死率,但平均用药时间及平均住院日无明显变化。OBJECTIVE To evaluate the effect of the management through the strengthening of the use of carbapenem antibiotics management.METHODS The antibiotics usage rate,the mean hospital stay,the mean cost of antibiotics,and the mortality of the patients who were treated with carbapenems before and after the management of carbapenems in our hospital from Jan.1to Nov.30,2016 were retrospectively analyzed.RESULTS The median usage rate of total antimicrobial agents before and after the management were respectively 42.76% and 43.38%,and there was no significant difference between the two groups.The median usage rate of carbapenems decreased from 4.27%to 2.53%（P〈0.05）.The median hospitalization days and the median use days of antibiotics before and after management had no significant increase.The median cost of antibiotics per patient were respectively1663.46 and 1704.12 yuan,and the difference was not significant.The proportion of antimicrobial agents to total hospitalization cost and medical cost were decreased after the implementation of management measures,but the difference was not significant.CONCLUSIONAfter the implementation of management measures,the usage rate of carbapenems was significantly reduced,and the mean cost of antibiotics and the mortality showed a downward trend.The mean hospitalization days and antibiotics use days were not significantly changed.

关 键 词：抗菌药物 碳青霉烯类药物 抗菌药物使用率 病死率 

分 类 号：R472.9[医药卫生—护理学]