四川省某三甲医院抗菌药物临床应用整治措施及持续改进  

Rectification methods and continual improvement on clinical antimicrobial use in a tertiary first-class hospital of Sichuan province

作　　者：陈相军[1] 管玫[2] 黄应德 刘芳[1] 于磊[2] 李念[1] 苑伟 杨梅梅[2] 陈敏[1] 

机构地区：[1]四川大学华西医院医疗质控科,成都610041 [2]四川大学华西医院药剂科,成都610041

出　　处：《中国抗生素杂志》2017年第12期1103-1106,共4页Chinese Journal of Antibiotics

基　　金：四川省软科学研究计划基金(No.2015ZR0186)

摘　　要：目的回顾性分析四川省某三甲医院抗菌药物管理措施及持续改进情况。方法从医院HIS系统收集和分析医院2011年1月—2016年12月抗菌药物数据。结果整治后和持续改进阶段的门急诊抗菌药物处方比例、急诊静脉使用抗菌药物使用率、住院患者抗菌药物使用率、住院患者抗菌药物使用强度、特殊使用抗菌药物使用率和使用强度、接受限制使用级抗菌药物治疗患者微生物送检率和接受特殊级使用级抗菌药物治疗患者微生物送检率低于整治前(P<0.05)。此外,Ⅰ类切口手术围手术期抗菌药物预防用药率、Ⅰ类切口手术围手术期术前0.5~1h抗菌药物预防用药比例、Ⅰ类切口手术抗菌药物疗程控制在24h内比例好于整治前(P<0.05),抗菌药物使用合理率高于整治前(P<0.05),同时整治后和持续改进阶段之间也有统计学差异性(P<0.05)。结论抗菌药物应用日益合理,但仍需探索新的管理措施促进抗菌药物合理使用,遏制细菌耐药。Objective A retrospective analysis of rectification methods and continual improvement on clinical antimicrobial use in a tertiary first-class hospital of Sichuan province. Methods Antimicrobial data from HIS system during January 2011 and December 2016 were collected and analyzed. Results After implementing rectification and subsequent continuous improvement of antimicrobial use, the ratio of antimicrobial prescriptions in the outpatient department and the emergency department, the ratio of antimicrobial use by intravenous administration, and the percentage of total hospitalization antimicrobial use, and the ration and the use intensity of special antimicrobial agents were improved significantly compared to those before implementing rectifications （P〈0.05）. In addition, the antimicrobial prophylactic use rate before operation in patients with class I incisional operation after rectifications was lower than that before rectifications, while the percentage of antimicrobial agents used 0.5-1h before operation and the ration of controlled treatment course within 24h was higher than that before rectifications （all P〈0.05）. There were significant differences in rational ration of antimicrobial use among all groups （all P〈0.05）. The use rates in the aforementioned antimicrobial management after implementing rectifications and subsequent continuous improvements were significantly different （all P〈0.05）. Conclusion The antimicrobial use has became more rational after special rectifications. However, this still needs new management methods to promote intelligent use of antimicrobial agents and to prevent bacteria resistance.

关 键 词：抗菌药物 整治 管理 感染 三甲医院 

分 类 号：R978[医药卫生—药品]